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Tenants Insurance Quote Form
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Tenants Insurance Quote Form
  Information About You
* First Name:
* Last Name:
* Address:
* Postal Code:   (A9A9A9 format)
* E-mail:
* Phone:   (10 digits only)
* Date of Birth:        
Spouse's Date of Birth:        
  Accurate phone number or email is important if you wish to be contacted
How did you hear about us:
  Your Insurance History
Have you ever had property insurance: Yes     No
If yes, for how many years?   (digits only)
Current insurance expiry date:        
Any claims in the last 5 years? Yes     No
  If you have had any claims, please give us the date and type of loss:
First claim:            
Last claim:            
  Coverage Information
  Enter the amount of contents insurance required for your home:
    (digits only)
          Yes     No Do any of the following statements apply to this quote?.
  You have made three (3) or more property insurance claims in the past five (5) years
  You have three (3) or more mortgages.
* Enter the code as it is shown:

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