Homeowners Insurance Quote Request

Please take a moment to fill out the form below and one of our representatives will contact you with a free, no-obligation quote.

PRIVACY PRE-NOTIFICATION: The Howard French Insurance Agency has a privacy policy to protect and keep this information  confidential and will be used for quote purposes only.

* Required fields.

Personal Information
How did you hear about us
Coverage Effective Date *
Name *
Date of Birth *
Marital Status *
Spouse's Name *
Spouse's Birth Date *
Address: *
City: *
State: *     Zip: *
Previous Address *
City *
State: *     Zip:
Daytime Phone: *  Night Phone:*
Best Time To Call:   AM   PM
E-mail Address: *
Occupation:   How Long at Current Job:

Current Homeowners Insurance Information
Company Name
(not agency):
Policy Expiration Date:           Years Insured:
Premium Amount: $
House Insured For: $
New Home Purchase *Yes      No 
Purchase Price: $
Loan Amount: $
Construction *
Year Built *
Square Footage *
Home Many Stories *
Foundation *
Use *
Townhome? *Yes      No 
Condo? *Yes      No 
Garage *
New Roof Year *
New HVAC Year *
New Plumbing Year *
New Electrical Year *
Realtor Name & Number *
Mortgage Person Name & Number *

Do You Have High Value Items?
Jewelry: $
Silver: $
Furs: $
Fine Arts: $
Cameras: $
Other: $

Additional Comments or Questions

Please click the "Submit Quote" button to send your quote request. No coverage is in effect until bound by an insurance carrier. This is a request for quotation only.



**Privacy Policy Notification**

In order to determine your eligibility, we are required to verify your loss history and credit history using consumer reports. You understand and agree that any personal information about you that you provide or that we obtain from any consumer report may be used by any company within the Nationwide Insurance group of insurance companies to issue, review and renew the insurance for which you are applying. You have the right to access and correct all personal information collected.

If you do not want us to order a credit and claims report, we can still provide you with a conditional quote; however without these reports, the quote may be rather inaccurate and cannot be used as final rates for your mortgage company or budgetary purposes.


The Howard French Insurance Agency
2616 South Loop W., Suite 597
Houston, Texas 77054
281-677-9491 office | 281-677-9492 fax

"The greatest compliment we can receive is your referral."