Property Insurance


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Theiss Insurance Agency understands that your property is a very important part of your life. In fact, the single biggest investment you may ever make is your home. Are you sure you have adequately protected your home and other properties?

We offer property insurance products to customers throughout Harris and surrounding counties.

 

Property Insurance Products:

  • Homeowners
  • Farm & Ranch
  • Condo
  • Renters
  • Mobile Home
  • Tenant Dwelling
  • Flood
  • Personal Umbrella

 

You are only required to complete the first section of this form in order to receive a response from an agent. Any other information you would like to enter on this form is optional.




Primary Insured


Name Email Address
Address Day Phone
City Night Phone
State
Zip:
Best Time to Call  
AM  
PM
Date of Birth Preferred
Contact Method
Email  
Phone
Occupation Time at
Current Job
SSN

Spouse or Additional Insured


Name
Occupation
Date of Birth
SSN

Current Homeowners Insurance Information


Company Name (not agency):
Policy Expiration Date:   Premium Amount: $
Dwelling Amount Insured For: $     Policy Type: Primary Secondary
Contents Amount Insured For: $
Liability Coverage Limit: $
Deductible: Clause 1     Clause 2

Home Information


Address
City
State  Zip 
How Long At This Address:     Year Home Was Built:
Sq. Footage (excluding garage
and basement):
sq. ft.        # of Claims In Last 3 Years:
New Home Purchase?        # Closing Date:        # Purchase Price:
Occupants

Structure Information


Updates To Electrical? Yes No If so, what year
Updates To Plumbing? Yes No If so, what year
Type
Construction
Roof
Foundation
Garage
Age of roof: yrs.

Features


Bathrooms
Deck/Porch/Patio
Fireplaces
# of Full:  
# of Half:  
Deck Sq. Ft.:  
Porch Sq. Ft.:  
Screened Patio Sq. Ft.:  
# of Chimneys:  
# of Hearths:  

Additional Features


Heating System
Security Alarm
Fire Alarm


Central Air
Central Vac
Smoke Detector
Swimming Pool
Yes
Yes
Yes
Yes

Dogs? Yes   Breed: Trampoline? Yes
Acreage? Yes   How many acres:

Additional Comments



Describe any claims/losses in the last 3 years



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