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Submitting Application...
1
Type
2
Personal
3
Details
4
Finish
Step 1: What type of insurance would you like to get a quote for?
Homeowners
Renters
Condo
Auto
Business
Life
Please select at least one insurance type.
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Step 2: Personal Information
First Name *
Required
Last Name *
Required
Date of Birth *
Required
Email Address *
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Phone Number *
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Street Address
City *
Required
State *
Required
ZIP *
Required
Preferred Contact Method (Select all that apply)
Email
Phone
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Step 3: Detailed Information
Homeowners Information
Same property address as above
Property Street
Property City
Property State
Property ZIP
Do you own or rent the property?
Select
Own
Rent
Year Built
Type of Residence
Select
Single Family
Multi-Family
Condo
Apartment
Estimated Property Value
Number of Residents
Any prior claims (5 Years)?
Select
Yes
No
Desired Coverage Amount
Renters Information
Same property address as above
Property Street
Property City
Property State
Property ZIP
Do you own or rent the property?
Select
Own
Rent
Type of Residence
Select
Single Family
Multi-Family
Condo
Apartment
Number of Residents
Any prior claims (5 Years)?
Select
Yes
No
Estimated personal belongings coverage
Select
100k
200k
300K
500K
750K
1MM+
Condo Information
Same property address as above
Property Street
Property City
Property State
Property ZIP
Do you own or rent the property?
Select
Own
Rent
Year Built
Type of Residence
Select
Single Family
Multi-Family
Condo
Apartment
Estimated Property Value
Number of Residents
Any prior claims (5 Years)?
Select
Yes
No
Desired Coverage Amount
Auto Details
Vehicle Year, Make & Model
Vehicle Identification Number (VIN) (optional)
Primary Use
Select
Commute
Pleasure
Business
Average Annual Mileage
Driver’s License Number
Any prior accidents or violations in last 5 years?
Select
Yes
No
Desired Coverage Type
Select
Liability
Full
+ Add More Vehicle/Driver
Business Details
Business Name
Business Type
Select
LLC
Corporation
Sole Proprietor
Industry
Years in Business
Number of Employees
Annual Revenue
Business Location Address
Coverage Needs
Select
General Liability
Property
Workers’ Comp
Life Insurance Details
Gender
Height & Weight
Tobacco Use
Select
Yes
No
Coverage Amount Desired
Term Length (for term life)
Any major health conditions?
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Step 4: Review & Submit
Thank you for your interest in Insurance options with the J. Fox Agency! Once complete, one of our licensed agents will reach out via phone. I provide my express written consent and authorization to the J. Fox Agency and/or the agents to contact me for marketing/telemarketing purposes at the number and address I have provided above, including my wireless number if provided, using live agents, SMS/MMS text messages, and/or emails, if applicable, even if I have previously registered the provided number on a company and/or any Federal or State Do Not Call Registry. *
Please agree to terms to continue.
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Insurance Coverage Provided by
A+ Rated Insurance
Companies
Sylvania
Toledo
Northwood
Sylvania
Location
5758 Main St. Suite 3
Sylvania
OH
43560
Office Hours
Mon
8:30 AM - 5:00 PM
Tue
8:30 AM - 5:00 PM
Wed
8:30 AM - 5:00 PM
Thu
8:30 AM - 5:00 PM
Fri
8:30 AM - 5:00 PM
Sat
Closed
Sat
Closed
Toledo
Location
5415 Secor Rd
Toledo
OH
43623
Office Hours
Mon
8:30 AM - 5:00 PM
Tue
8:30 AM - 5:00 PM
Wed
8:30 AM - 5:00 PM
Thu
8:30 AM - 5:00 PM
Fri
9:00 AM - 5:00 PM
Sun
Closed
Sun
Closed
Northwood
Location
3040 Woodville Rd
Northwood
OH
43619
Office Hours
Mon
8:30 AM - 5:00 PM
Tue
8:30 AM - 5:00 PM
Wed
8:30 AM - 5:00 PM
Thu
8:30 AM - 5:00 PM
Fri
8:30 AM - 5:00 PM
Sat
Closed
Sat
Closed
After-hours appointments available
Available 24/7 at
(419) 725-2582