Khalsa Insurance Agency
California License # 0F89805
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Home / Renters / Condos Insurance Quote Form...
Full Name:
Home Phone Day Time Phone
E-Mail Address:
Who is this Quote for?
  Quote Type
Select Quote Type:
  Home Info.
Month of Purchase of Home?
Purchase Price: $
Type of Home:
Year Built:
Type of Construction:
Square Feet:
  Electrical & Security Info.
Electrical System:
Security Alarm:
Central Air Conditioning:
  Home Structure Info.
No. of Fire Places:
No. of Bathrooms
No. of Bedrooms:
Type of Garage:
Swimming Pool:
Have you made a Claim in the
Past 5 Years?
Your Current Home Insurance Carrier:
HOME Insurance
Do I Need Insurance?
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