To obtain a free no obligation quote for your home and other insurance needs, use the form below and an agent from Farmers Mutual Insurance Company of Clinton County will contact you.
Name:
Street Address:
City, State, and Zip:
Phone:	(XXX) XXX-XXXX
Preferred Calling:	AM   PM   Please Specify
Alternate Phone:	(XXX) XXX-XXXX
E-mail:
Type of Home:	Single Family   Mobile Home
Year Built:
Square Footage:
Construction Type:	Frame   Brick Veneer
Roof Type:	Asphalt Shingle   Wood Shingle   Tile or Slate       Metal
Age of Your Roof:	years
Foundation:	Basement (Full)   Crawl Space  Slab                   Underpinned
Do you live on more than 1 acre of land?	Yes   No        If Yes, How Many? acres
Present Coverage:
Dwelling:
Other Structures:
Personal Property:
Loss of Use:
Liability Limits:
Medical Payment Limits:
Optional Coverages:
Earthquake:
Replacement Cost/ Personal Property:
Sewer Backup:
Additional Information:
	Please Check Your Information Before Submitting.