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Get A Quote
- Personal
- Commerical
Policyholder Area
Ledbetter on TV
About Us
- Our Staff
Contact Us

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Home Insurance Peoria Illinois Quote Form

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Ledbetter Insurance Homeowners Quote Form

We would love to hear from you! Please fill out this form and we will get in touch with you shortly.

1Personal Information

2Property Information

3Current Coverage Information

Hidden
Insured Last Name:
Insured Full Name:
Hidden
Insured Middle Name:
Return Call Phone Number
Email*
Date of Birth (For discount purposes):*
YYYY slash MM slash DD
How would you rate your credit?

Property Address Street:
City:
State:
Zip Code:
Current Worth of Home:
Number of Families?
What is the dwelling type?
About what year was it built?
What year was the property purchased?
Is this a new purchase?
- Yes
- No
Close Date
Year
Year
Year
What is the construction type?
How many stories?
Do you need coverage for a garage?
- Yes
- No
Is(Are) your garage(s) attached or detached?*
- Attached
- Detached
- Both
If detached, how much would you like to insure it for?*
If detached, frame or masonry*
- Frame
- Masonry
Amount:
What is the condition of the garage?
Comments:
Does the building have a pool?
Is the electrical updated?
Are there circuit breakers?
Is the heating/ air conditioning thermostatically controlled?
Do you have a trampoline?
Number of acres dwelling is located on:
Are there dogs on the property?
If yes, how many and what is the breed of each dog?
Are there any other pets or animals on the property?
If yes, how many and what is the description of each?
Is your home inside the city limits?
Are there handrails on all steps exceeding two steps?
General Condition of Home:
Who is paying the first year premium?
Mode of payment:
What is your current insurance company?
What is the expiration date of current policy?
MM slash DD slash YYYY

Dwelling Amount:
Other Structures:
Personal Property:
Premise Liability:
Policy Deductible:*
Do you want actual cash value policy or a policy to rebuild new?
Do you want contents replacement cost coverage?
Do you want sewer and sump pump coverage?
Have you insured this home in the last thirty days?*
- Yes
- No
How many months has the house been uninsured?*
Additional Information
Is there a vacant dwelling next to your home?
If yes, explain at bottom of page.
Where there any losses or claims in the last 5 years?
If yes, explain at bottom of page.
Is your home currently in need of or under any repair or renovation?
If yes, explain at bottom of page.
Questions or Comments
NOTICE: Some companies use an insurance score. This can often improve your rate. If you would like us to use this underwriting tool please provide us your social security number in the remarks box below. (Rules of the Fair Reporting Credit Act and Federal Consumer Credit Protection Law, will apply)
Phone
This field is for validation purposes and should be left unchanged.

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