Michael L. Hodge

e: info@mlhodgeinsurance.com

Toll Free: 866.921.8479

p: 661.295.8905

c: 818.590.5698

f: 661.554.7190

22946 Lyons Ave

Newhall, CA 91321

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Name 
Email 
Telephone 
Property Address
Property City
Property State
Property Zip
  

Home Information:
Year home built:
Square feet:
# of stories:
# of bathrooms:
Type of roof (tile, asphalt, shingle):
Garage Type:
Exterior Type (stucco, frame, etc):
Central Burglar Alarm, Yes/No:
Fireplace, Yes/No:
# of losses in last three years:
New Purchase or Current Residence?
Primary Res. or Investment?
Requested Effective Date:

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