Georgia insurance

"Experience GA, TN, SC, & MO Residents & Businesses Can Count On."
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Georgia auto insurance
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Georgia auto insurance
 
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Auto Insurance!
770-434-6691


 
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5 Reasons Why You Should Use Our Insurance Services:

1. Excellent coverage at very competitive prices.

2. FAST online quotations for auto, homeowners, and life, and INSTANT quotes by phone.

3. Low down payment & Easy monthly installments on most policies.

4. Our service is second to none. Call us and get an agent who really CARES!

5. We offer a satisfaction guarantee. We know our top quality coverages and service will SATISFY you!

Remember...
"All Our Policies Come With an Agent!"

Clemmons Insurance Agencies has helped thousands of Georgia, Tennessee, South Carolina, and Missouri residents and businesses find the lowest rates available and the best insurance plans to protect their cars, homes, businesses, and families. Let us do the same for YOU! Our office includes a state-of-the-art computer system for policy services, claim servicing and accounting so that quality service is GUARANTEED. Your needs will be addressed, phone calls returned, and coverage issues responded to, and claim matters will be addressed...WITHIN 24 HOURS!

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On-Line Life Insurance
Quotation Form
One Simple Form - takes only 2-3 Minutes!


Your Personal Data:
 
Your Name:
Street Address:
City:
State:
Zip Code:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
Primary Insured's Occupation:
 
Are You Married?
Yes No
Currently Insured?
Yes No
 
If currently covered list carrier, # of years covered, and type of coverage
 
Unusual Activities?
(If you engage in unusual activities such as scuba diving, airplane flying, rock climbing, etc., list them here.)


Underwriting Information:
 
Name of Proposed Insured:
Enter Proposed Insured's Birthdate:  
Sex (M/F): Do You Smoke?:
Height: Weight:
Spouse's Information:
(Leave Blank if you do NOT want Spouse Coverage)
 
Name of Spouse:
Enter Spouse's Birthdate:  
Sex (M/F): Do You Smoke?:
Spouse Height: Spouse Weight:



Coverages:

Amount of Coverage Desired?
 
Type of Life Coverage Desired?
 
TERM = Pays death benefit only - This is lowest cost for coverage.
UNIVERSAL LIFE = Has savings aspect in addition to providing death benefit.
OTHER = Would be mortgage protection, whole life, no-exam life, etc.
 
Years of Level Premium, if selecting term life.
 
List Any Health Problems:
 
Reason for Buying Life Insurance:
 
Send my quotation via: E-Mail Fax
Regular Mail
Call Me by Phone


Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a
Life Insurance Quote NOW!


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GA auto insurance
 
Please contact our agency at the address and phone numbers below for a free quotation today. We have the service you are looking for!

Clemmons Insurance Agencies - Smyrna, GA Office
1326 Concord Road, Smyrna, GA 30080
Phone: 770-434-6691
Fax: 770-434-6779
Email: Click Here to Email Us | Click for Map/Directions

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