Lily Ho of JPL Financial and Insurance Services Inc. - Homeowners Insurance : Quote Request

Lily Ho is a Registered Representative offering services through JK Fiancial, Inc. A Member of FINRA,SIPC Office: 149 Cross Rail Lane, Ste 102, Norco, CA 92860. Tel 714-704-1818. Ms. Ho is registered to discuss and /or transact securities service business only with residents of the following states: California and Texas. No offers may be made or accepted from any resident outside these state.

Certified Financial Planner Board of Standards, Inc. (CFP Board) owns the certification marks CFP®, CERTIFIED FINANCIAL PLANNER™, and CFP® (with plaque design) in the United States, which it authorizes use of by individuals who successfully complete CFP Board's initial and ongoing certification requirements.


» Name:
Address:
City:
State:
Zip:
» Home Phone:
Work Phone:
» Email:
Age:

Insurance Type:	Single Family Townhouse Condo Renters
If multi-family bldg, how many residential units:	1-4 5-12 12+
Construction Type:	Frame Masonry Masonry Veneer
Year Built:
Nearest Fire Hydrant:	under 1000 feet none
Nearest Fire Department:	1 2 3 4 5 5+ miles
Smoke Detector:	Yes No
Deadbolt Locks:	Yes No
Fire Extinguisher:	Yes No
Central Station Fire Alarm:	Yes No
Central Station Burglar Alarm	Yes No
Swimming Pool:	Yes No
If yes, is it fenced in:	Yes No
Wood Burning Stove:	Yes No
Do you have a dog:	Yes No
Market Value $:
Existing dwelling coverage amount $:
Desired Coverage Amount $:
Liability Limit $:
Deductible:	250 500 1000
Any special coverages:
Current Insurance Company:
Expiration date (or settlement if new purchase):
Any claims past 5 years:
Please use the space below to add comments regarding any special circumstances.