Newsflash

Ames Insurance Agency has moved back to their original location. We have also had our website overhauled by JPDiamond Company. Let us know what you think.
 

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Get a Quote For Life Insurance
Ames Insurance is an independent agency, which means we write insurance for many different companies.  By completing the questionnaire below you will give us the necessary information to offer you an accurate quote.

Fill out this questionnaire completely for a free quote! (or e-mail us and ask us to contact you)
First and Last Name:
Address:
City: State:   Zip:
Home Phone(with area code):
Work Phone(with area code):
Fax number(with area code):
E-mail address:
Contact us:
If Insured, select the company insured with:

1st Person Data

First name Age Height Occupation
Smoker Sex M/F Weight  
 
Type of Policy Coverage amount
Pleaser enter a brief description of present physician care.

2nd Person Data

First name Age Height Occupation
Smoker Sex M/F Weight
 
Type of Policy Coverage amount
Pleaser enter a brief description of present physician care.

3rd Person Data

First name Age Height Occupation
Smoker Sex M/F Weight
 
Type of Policy Coverage amount
Pleaser enter a brief description of present physician care.

4th Person Data

First name Age Height Occupation
Smoker Sex M/F Weight
Type of Policy Coverage amount
Pleaser enter a brief description of present physician care.

Questions / Comments:
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