Rich Tadych

Insurance Center of Milwaukee

For a Quote

1. Names of drivers, dates of birth, and driver license numbers

2. Current address (list prior address as well if less than 1 year at current address)

3. Year, Make, and Model of vehicles (serial numbers would be helpful)

4. Type of coverage requested (liability, comp, collision, etc.)

5. Name of current insurance company (list "none" if no prior insurance)

6. When does your current policy expire

7. List any accidents, tickets, or claims in the last 5yrs

1. Names of owners and dates of birth

2. Address of home (list prior address if less than 1 year at current address)

3. For how much would you like to insure the house

4. Type of siding, square footage, age of roof, garage attached or detached

5. Style of home (ranch, cape cod, etc.) and year built

6. Date coverage is needed

7. List any claims in the last 5 years