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Coverage Details

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Manufactured Home Quote Request

Contact Information
Community Name		POS
Contact Person		Phone
Email*		Fax
First Name	Last Name	Spouse/Secondary Name
Mailing Address
City	State	Zip
DOB MM/DD/YYYY	Spouse/Secondary DOB



Property Information

Use of home: PrimarySeasonal
Value of Home		Purchase Date
Purchase Price
Year of Home	Make/Model
Serial Number	Length	Width
Location Address
City	State	Zip


Is land owned by the client? YesNo
Amount of personal property
Attached Structures (Florida rooms, Screen rooms, etc.)
Unattached Structures
Personal Liability $100,000$300,000







By submitting this form I agree to be contacted by Thousand Trails Insurance Group, LLC regarding recreational vehicle insurance. I understand that Thousand Trails Insurance Group, LLC will not use or provide this information form for any other purpose than to contact me regarding insurance.















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Read Your Policy Carefully. This brochure contains summaries of coverages that are available. For a complete description of coverages, exclusions, conditions and limitations, please refer to and read your policy carefully. Coverages underwritten by one of the following: In CA: AFH Insurance Company and American Modern Insurance Company. Other States: American Modern Home Insurance Company, American Family Home Insurance Company, American Southern Home Insurance Company, and American Modern Select Insurance Company.

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