Farm/Ranch Insurance Quote

To obtain a free, no-obligation quote for farm/ranch insurance, fill out the form below and click on the 'Submit Form' button and we will contact you. If you prefer to give information over the phone, fill out the name and daytime phone number fields only and we'll give you a call.

If you would rather mail us this information, fill out the form and click on the 'Print This Page' button at the bottom of this page and mail to Hermes Insurance, P.O. Box 339, Sanger, TX 76266. You can also fax the completed form to us at (940) 458-4466.

Have any other questions? Please call us at (940) 458-4664

Name:
Current Address:
City:
State:
Zip Code:
Daytime Phone:
Email Address:
DOB:
Spouse Name:
Spouse DOB:
Have you had your home or auto insured with Germania Insurance before?:
Current Insurance Company:
Expiration/Closing Date:
Bankruptcy, Foreclosure, Reposession in Last 5 Years:
Fire plug within 1,000 feet:
Responding Fire Dept:

Rating Data:

Address to Insure:
City:	State: Zip:
Acreage:
Sq. Ft. of Home (Living Area):
Year Home Was Built:
Construction of Home:
Number of Stories:
Foundation Type:
Roof Construction:
Roof Age:
Garage Attached:
Number of Bedrooms:
Number of Bathrooms:
Pool:	If Yes, diving board or slide?:
Trampoline:
Dogs:
Breeds:
Acres Owned:	Acres Leased to Others:
Acres Leased from Others:
Livestock? What type?:
Monitored Fire Alarm:	Monitored Burglar Alarm:

Estimated Home Value:

Optional Coverages Available:

Check All That You Wish To Include In The Quote:	Jewelry Saddles & Tack	Art Objects Farm Equipment	ATV's Farm Outbuildings

Outbuilding Coverage

Please describe any barns,
equipment sheds, etc
on the property:

Equipment/Machinery Coverage

Please describe any equipment
or machinery that should
be specifically covered:

Other Coverage

Is Hay Coverage Needed?:

Claims:

Any home claims in the past 5 years?

If so describe... (Date, Claim Type & Amounts Paid.)

Comments:

**No insurance coverages are bound from this web site.**