Khalsa Insurance Agency
California License # 0F89805
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Flood Insurance Quote Form...
Full Name:
Home Phone Day Time Phone
E-Mail Address:
Insured Person 1 Details:
Name Date of Birth SSN Occupation
Insured Person 2 Details:
Name Date of Birth SSN Occupation
  Property Location Info.
Property Address:
  Property Exterior Info.
Year Built:
Square Foot:
1, 2 Storied or more:
Roof Type:
Age of Roof:
How many Cars can the Garage Accommodate?
Garage Attached or Detached?
Swimming Pool:
Yes / No Fenced Above Ground
  Property Interior Info.
How many Bedrooms?
AC / Heaters:
How many Bathrooms?
Are there any Fireplaces?
If yes How many Fireplaces?
Special Features:
  Additional Legal Info.
Any claims in the last 3 years:
Date Type of Claim Payout $
  Mortgage Info.
Loan Number:
FLOOD Insurance
Do I Need Flood Insurance?
Flood Insurance Quote
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    Legal Information   |   Khalsa Insurance Agency Inc. 2020