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Home » About Our Agency » Meet Our Team » Team Member

Brent Saunders

Insurance Agent

Meet Brent Saunders

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About Our Agency - Alliance Insurance Group Meeting With Clients and Discussing Insurance in the Office

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Name*

First Name* Last Name*

Phone Number*

Phone Number*

Email*

Email*

Date of Birth

MM slash DD slash YYYY Date of Birth

Choose the insurance type that works best for you.

Home Insurance

Auto Insurance

You can select either Home, Auto, or both.

Home Insurance

Address

Street Address City State/Prov./Region ZIP/Postal

Desired Policy Start Date

MM slash DD slash YYYY Desired Policy Start Date

Married?

Yes

No

Spouse Name

Spouse Name

Spouse Date of Birth

MM slash DD slash YYYY Spouse Date of Birth

Does the home have a Wood Burning Stove?

Yes

No

Does the home have a Trampoline?

Yes

No

Does the home have a Pool?

Yes

No

If so, In-ground or Above?

In-ground

Above

If so, is there a Fence Around the Pool?

Yes

No

Approximate Roof Age

Approximate Roof Age

Siding Type

Siding Type

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Foundation Type

Foundation Type

Does the home have a basement?

Yes, crawlspace

Yes, partial

Yes, full basement

No

If yes, is it finished?

Yes

Partially finished

No

How are the basement walls constructed?

Dog?

Yes

No

If yes, what Breed?

If yes, what Breed?

Current Address

Street Address City State/Prov./Region ZIP/Postal

Ignore if same as above.

Do you have another property you’d like to add to this policy?

Yes

No

Additional Property

Does the home have a Wood Burning Stove?

Yes

No

Does the home have a Trampoline?

Yes

No

Does the home have a Pool?

Yes

No

If so, In-ground or Above?

Yes

No

If so, is there a Fence Around the Pool?

Yes

No

Approximate Roof Age

Approximate Roof Age

Siding Type

Siding Type

Does the home have a basement?

Yes, crawlspace

Yes, partial

Yes, full basement

No

If yes, is it finished?

Yes

Partially finished

No

How are the basement walls constructed?

Dog?

Yes

No

If yes, what Breed?

If yes, what Breed?

This field is hidden when viewing the form

Auto Insurance

There are multiple ways to collect your auto information. Please select which option is best for you by completing ONE option below:

Document Collection Portal (Recommended, Quickest Option)

Complete Auto Questionnaire Below to the Best of your Ability and Submit.

Email Me Your Current Insurance Policy’s Declaration Page.

Get Started Here.

This link opens in a new tab. Make sure to finish submitting this form as well!

Email your declaration page to .

Make sure to finish submitting this form as well!

Auto Questionnaire

Driver's License Number

Driver's License Number

Occupation

Occupation

Education Level

Education Level

Spouse Name

Spouse Name

Spouse Date of Birth

MM slash DD slash YYYY Spouse Date of Birth

Spouse Phone

Spouse Phone

Spouse Email

Spouse Email

Spouse Driver's License Number

Spouse Driver's License Number

Spouse Occupation

Spouse Occupation

Spouse Education Level

Spouse Education Level

Additional Drivers

Please list name, date of birth, ID #, occupation, and education level for any additional drivers. Click "add" to list additional drivers.

Home Address

Street Address City State/Prov./Region ZIP/Postal

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Current Insurance Company and Rate

Current Insurance Company and Rate

Payment Method (Monthly or In-Full?)

Payment Method (Monthly or In-Full?)

Any Driving Violations

Yes

No

If Yes, Please Explain

If Yes, Please Explain

Vehicle Information (Year, Make, and Model)

Please list year, make, and model for each vehicle. Click "add" to list additional vehicles.

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Any other comments?

Any other comments?

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About Alliance Insurance Group

Alliance Insurance Group is an independent insurance agency offering a comprehensive suite of insurance solutions to protect you from the unexpected.

Safeguard Insurance Group, LLC is a proud partner with Alliance Insurance Group.

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Columbus, OH

1355 King Avenue
Columbus, OH 43212

614-665-0155

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About Our Agency
- Meet Our Team
  - Join Our Team
- We Are Independent
Personal Insurance
Client Center
Contact Us
- Columbus, OH
- Schedule a Meeting
Get a Quote

Call
Text to 614-665-0155

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