Protect Your Home & What’s Inside

Name *

Email address *

Phone *

Property Address *

I am *

Homeowner (live here)

Tenant (renter)

Landlord (rent to others)

Condo owner

Dwelling Type *

Year Built (approx.)

Square Footage (approx.)

Basement finished?

Yes

No

Partial

Primary Heating

Quote Type (select all that apply) *

Please select at least one option.

Homeowners

Condo

Tenant

Landlord (Rental)

Liability Limit

Deductible Preference

Contents / Personal Property (renters/condo)

Add-ons (select any)

Please select at least one option.

Sewer backup

Overland water

Equipment breakdown

Identity theft

Condo improvements & betterments

Loss of rent (landlord)

Monitored Alarm

Yes

No

Smoke/CO Detectors

Yes

No

Electrical Type

Plumbing Type

Bundle with Auto for discounts?

Yes

No

Number of Residents

Any home business operations?

Yes

No

Short-term rental (Airbnb/VRBO)?

Yes

No

Pool or Trampoline?

Pool

Trampoline

Both

Neither

Animals?

Yes

No

Current Insurer

Policy Renewal Date

Claims in the last 5 years? *

Yes

No

If yes brief explanation

Best Contact Time

Contact Method

Phone

SMS

Email

Consent to Connect *

Please select at least one option.

I consent to Sharked Group sharing my intake with vetted insurance partners so they can contact me by phone, SMS, or email.