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Park Model & Mobile Homes

Park Models And Mobile Home Insurance

Park Models And Mobile Home Insurance
Arizona & California

Thank you for considering Sheltra Insurance Group, LLC for an Online quote submission. Please provide as much information as available within the application, below, for the most accurate quote(s).

Upon completion of this information, hit "submit" once and the form will be sent to a representative for quoting. The information provided will then be quoted among the multiple insurance carriers our office proudly represents.

A representative will respond with the quote(s) via the contact option selected, below, normally within 1 business day.

*If you have any difficulty with this application or prefer to speak with an associate directly, please call us at: 928-317-1212.

Young Couple Shaking Hands with a Female Agent — Yuma, AZ — Sheltra Insurance

For your convenience, you may also submit a copy of your existing insurance policy, below, by utilizing this Submit Document button.

Submit Document

Applicant Information

APPLICANT INFORMATION

*First Name

*Last Name

*Date of Birth

Marital Status

*Address of home

*City

*State of the Property

*Zip Code

Is this home in a RV Park?

No- Private Land

*Yes

*If yes, what is the name of the Park?

*Is the Park a 55+ Community?

Yes

Full Mailing address (if different than above)

Co-Applicant Information

CO-APPLICANT INFORMATION

First Name

Last Name

Date of Birth

Relation to Insured

Is the Co-applicant a Co-signer/Co-owner of the Park Model/Mobile Home?

Yes

Is the Co-applicant on the Title of the Park Model/Mobile Home?

Yes

Contact Information

CONTACT INFORMATION

Daytime/Home Phone #

*Cell Phone #

Work Phone #

*E-mail

Preferred method of contact [Select all that apply]

Home Phone

Cell Phone

Work Phone

E-mail

Text [This will be Limited Contact Option. ]

Person of Contact

Is the person of contact a

Realtor

Bank/Loan Officer

Other (explain below)

If the person on contact is a Realtor or Bank/Loan Officer, please enter their phone # and the name of the office they represent

Financial Information

FINANCIAL INFORMATION

Home Ownership status

How long have you owned the home?

Lienholder/Bank Name

Lienholder/Bank Address

Lienholder/Bank City

Lienholder/Bank State

Zip Code

Loan # (Optional)

Coverages Requested

COVERAGES REQUESTED

*Requested effective date

*Requested amount of insurance

Purchase Price (USD)

*Type of Coverage Requested- Select

Optional Coverages?- List and we accommodate as available

Does the amount of the requested Park Model/Mobile Home insurance include the value of the land?

*Yes

Property Information

PROPERTY INFORMATION

*Property Type

*Occupancy

*Year of the Park Model/Mobile Home?

Manufacturer/Make of the Unit

Model name, if applicable

Serial # (Optional for quote)

*Length

*Width

Please describe the type of Foundation

Concrete Slab/Flat on the Ground

On Stands/Jacks- Fully Skirted

Wheels and Hitch- Unskirted

Pit Set- with Crawlspace

Other (explain below)

Other type of Foundation

What type of Siding materials?

Hardboard/Hardi-board

Aluminum

Vinyl

Metal [Other than Aluminum]

Other (explain below)

Other type of Siding

What type of Roofing materials?

Shingles (Asphalt/Comp)

Tile (Clay)

Metal

Rolled roof (tar and gravel)

Other (explain below)

Age of the Roof? [Original or when was it last updated?

Other type of Roofing materials

What type of Heating source?

Heat pump

Forced Air

Electric- baseboard

Furnace- gas or electric

Other (explain below)

Other type of Heating source

Is there a Fireplace in the home?

*Yes

*If yes, how many? Wood, Gas..or Electric?

Is there a Swimming Pool on premises; (private land owners)?

*Yes

*If yes, is the Pool completely fenced with a self-locking gate?

Yes

During the time you have owned the home, have there been any losses and/or claims on the home in the past 5 years?

*Yes

*If yes, please give information on what type of loss/claim, such as wind or water, apx. when the loss occurred and how much was paid out on the claim:

Other Information

OTHER INFORMATION

Has this Park Model/Mobile Home had insurance coverage, in your name, for the past 12 full months?

*Yes

*If yes, with what company?

*Is this Policy still in force?

When does the existing Policy expire?

Do you have any other structures on the property, such as a shed?

*Yes

*Please describe type of structure and size

Do you have a Garage or Carport?

Option 1

*Yes

Is the Garage or Carport attached or unattached from the main house?

*Attached

Unattached

*If attached, what is the Length and Width of the Garage or Carport?

Do you have any Dogs [or other undomesticated Animals] on the property?

*Yes

*What type/breed of Dog and how many? [Or description of other undomesticated Animals]

What is the primary insureds occupation? (Ex. Retired)

Comments/Special Notations

I authorize the Sheltra Insurance Group to verify my credit and/or insurance history.

Thank you for contacting us.

We will get back to you as soon as possible.

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Phone: (928) 317-1212 | Address: 670 E. 32nd St. Suite 12, Yuma, AZ 85365 | Email: Sheltrainsurance@yahoo.com

Phone: (928) 317-1212

Address: 670 E. 32nd St. #12 Yuma, AZ 85365

Email: Sheltrainsurance@yahoo.com

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Park Models And Mobile Home Insurance

Park Models And Mobile Home Insurance Arizona & California

Park Models And Mobile Home Insurance
Arizona & California