Phillips Insurance Services                     

 


                                                                                      
    


"Protecting Today for a Brighter Tomorrow"

Welcome to our quote page
Listed below are quote request for Home, Auto and Life Insurance.
Please take a few moments to tell us about you so that we may better serve you. If you have more than two cars or two drivers please add them in the comments secton.
Homeowners Quote Request:

Homeowners Quote Request

 

First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Year Built:
Square Footage:
Home Value:
Email:
Comments:

Auto Quote Request

Please tell us a little about you , the vehicle you drive and the members of your household.  If you have more than 2 cars, add the driver name, Date of Birth and vehicle information in the comments field.

Auto Insurance Quote Request

 

First Name Driver 1:
Last Name Driver 2:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Driver 1 Date of Birth:
Driver 1 Drivers License #:
Driver 1 Soscial:
Vehicle 1 Year Make Model:
Vehicle 1 VIN #:
Driver 1 # of Accidents Last 3 years:
Driver 1 # of Tickets Last 3 years:
Liability Limits:
Collision Deductible:
Other Than Collison/Comprehensive Deductible:
Current Carrier:
Current Premium:
Comments:

Auto Insurance Quote Request

 

First Name Driver 2:
Last Name Driver 2:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Driver 2 Date of Birth:
Driver 2 Drivers License:
Driver 2 Social:
Vehicle 2 Year Make Model:
Vehicle 2 VIN #:
Driver 2 # of at Fault accidents Lst 3 yrs:
Driver 2 # ofTickets Last 3 Years:
Vehicle 2 Liability Limits:
Vehicle 2 Collision Deductible:
Vehicle 2 Other Than Collision/Comprehensive Deductible:
Current Carrier:
Current Premium:
Comments:

Life Insurance Quote Request

There are two basic types of Life Insurance, Term and Permanent. Term provides level premium and coverage for a specified period of time (10, 20 or 30 years) then the coverage either expires or goes up in premium.   Permanent polcies cover you until after age 100. Some have Tax Preferred cash values that can be used to pay premiums or as a source of savings.  Please tell us a little about you and the coverage you are most interested and we will get back to you quickly with a plan that fits your needs.

Life Insurance Quote Request

 

First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Date of Birth:
Height Ft and Inches:
Weight Lbs:
List medical conditions:
Medications Taken:
Amount of Life Coverage Desired:
Term or Permant Coverage ?:
Length of Term 10, 20 or 30 years?:
Comments:

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