Georgia Townhome Insurance 1-877-MattLocke (628-8562) Town Home

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inexpensive Georgia Town-home Insurance

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11877 Douglas Road

Suite 203

Johns Creek, GA 30005

To contact us:

Phone: 678-893-9050

Fax: 678-893-9088

Toll Free: 1-877-MattLocke (628-8562)

E-mail: Sales@MattLockeandAssociates.com

Georgia Townhome Insurance.com

Having home insurance and Auto insurance with the same carrier provides significant discounts. Consider reviewing the coverages available at:

Georgia Auto Insurance

With the added liability risk, review the additional liability coverage available at:

Georgia Umbrella Insurance

Applicant #1 Name
Birth date of Applicant 1
Applicant #2 Name
Birth date of Applicant 2
Current Mailing Address
Current City and County
Current State and Zip
Phone number
E-Mail Address
Address to be Insured
City and County
State and Zip
Are there units left and right? Or is this an End Unit?	Middle Unit	End Unit
Do you currently have Property Insurance?	Yes	No
What kind insurance and with who?
Is this a Primary or Secondary home?	Primary	Secondary
Type of home and Construction
Basement and Percentage Finished?
Wood deck?	Yes	No
Garage type and number of cars:
Is there heated living space above the Garage? Example: Bonus room or bedroom	Yes	No
How many stories does the home have?
Approximate Square footage of entire home excluding basement:
Year Built
Fire Places
Discounts
Deadbolt Locks, Smoke Detector, Fire Extinguisher?	Yes	No
Monitored Security/Fire Alarm?	Yes	No
Does your Subdivision have a Mandated Homeowner Association?	Yes	No
As part of the application process, we may collect personal information from persons other than you or other individuals proposed for coverage, including credit reports and loss information reports. This information, as well as other personal or privileged information subsequently collected by us, may in certain circumstances be disclosed to third parties without your authorization. You have a right of access and correction with respect to all personal information we collect. If you would like more detailed information in writing about our information collection practices, please let us know.

NOTE: In regard to the statement above, we are required to post this as a process of obtaining Loss Information History and final quoting criteria. Submitting this form approves the collection of data. We have not asked for and do not require a social security number in this process.