For a Home Email Quote, please fill
out the form below. If you are in the process of a loan
closing, refinancing or other lender requirement, please
call 1-800-41-TANGO (82646)
|
|
First
Name:
|
|
|
Middle Initial:
|
|
|
Last Name:
|
|
Mailing Address:
(Address, City, State,
Zip)
|
,
|
|
Phone:
|
ext.
|
|
Fax:
|
|
|
E-Mail Address:
|
|
|
If less than one year at current address ...
|
Previous Address:
(Address, City, State,
Zip)
|
,
|
|
Are you Currently Insured?
|
Yes
No
|
|
Amount of Dwelling Coverage:
|
|
|
Any bankruptcies, Tax Liens, Repossessions or Unsatisfied Judgments in 5 years?
|
Yes
No
|
Claims in Last Five Years:
(If none, leave blank)
|
|
Home Information
|
|
If different from current address ...
|
Property Address:
(Address, City, State,
Zip)
|
,
|
|
Year Built:
|
|
|
Type:
|
|
|
Square Footage:
|
|
|
Number or Stories:
|
|
|
Basement:
|
Yes
No
If yes, Square Footage of Basement:
|
|
Built On Slab:
|
Yes
No
|
|
Bathrooms:
|
Full:
Half:
|
|
Bedrooms:
|
|
|
Garage:
|
If yes, how many cars:
|
|
Hardwood Floors:
|
Yes
No
% Throughout House:
|
|
Carpet:
|
Yes
No
% Throughout House:
|
|
Fireplaces/Wood Burning Stoves:
|
|
|
Hearths:
|
|
|
Skylights:
|
|
|
Balcony, Decks, or Screened in Porches:
|
Yes
No
If yes, Square Footage:
|
|
Central Air/Heat:
|
Yes
No
|
|
Ducts:
|
|
|
Heat Type:
|
|
|
Central Station Alarm:
|
Yes
No
|
|
Additional Information:
|
|
|
How would you preferred to be contacted?
|
|
|
If we need to speak with you, when is the best day/time to call:
|
|
|
How did you hear about tangotangotango.com
|
|
|
|
