Homeowners Quote

Contact Us

Toll Free:
1-800-375-8631

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Emergency Claims After-Hours:
800-375-8631, x588
or 918-491-8588

918-747-8631

5314 S. Yale Avenue, Suite 900
Tulsa, OK 74135

405-841-0100

11600 Broadway Extension, Suite 280
Oklahoma City, OK 73114

	You may also send a copy of your current policy in lieu of a completed form. Premium information is not necessary. Email to info@cfr-ins.com
	Basic Info
Name *
Address *	Invalid Input
City *	Invalid Input
Zip *	Invalid Input
Phone *	Please enter a valid phone number xxx-xxx-xxxx
Email	Invalid Input
Date of Birth *	Invalid Input

SS#	Invalid Input
Occupation	Invalid Input

	Home Info
Year Built *	Invalid Input
Construction Material *	Invalid Input
Stories *	Invalid Input
Usage *	Invalid Input
Sq. Ft.	Invalid Input
Age of Roof	Invalid Input
Roof Material *	Invalid Input
Protective Devices	Central Fire AlarmCentral Burglar AlarmLocal Alarm Invalid Input
Other	Swimming PoolTrampolineDogs Invalid Input
If yes to Dogs, list breeds	Invalid Input

Dwelling Amount	Invalid Input
Current Deductible	Invalid Input
Contents Value	Invalid Input
Other structures to be insured	Invalid Input
Additional Exposures (Watercraft, Earthquake, Flood, Business on Premises)	Invalid Input
Scheduled Items & Amounts (Jewelry, Furs, Fine Arts, etc.)	Invalid Input

Losses filed in Last 5 Years? *	YesNo Invalid Input
Mortgage?	YesNo Invalid Input
	Last years updated:
Roof	Invalid Input
Plumbing	Invalid Input
Wiring	Invalid Input
Heat & A/C	Invalid Input
Current Carrier	Invalid Input
Effective Date *	Invalid Input
Comments	Invalid Input
	Invalid Input