Thank you for your interest in receiving a vacant land quote from First Choice Insurance Group. This form should only take a few minutes to complete. Don't worry if you don't have everything. You can always click the "Save and continue later" button below. We'll email you a private link to pick up where you left off.
Are you planning to build on your land?*
- No
- Yes
This quote form is designed for persons who do NOT plan on building anything on their land. If you are planning on building in the near future it looks like you need a Course of Construction policy (aka Builders Risk Policy). Click the button below to get started with a course of construction quote.

Start Course of Construction Quote
Name*
First Last
Mobile Phone*
Email Address*
Date of Birth*
Month
Day
Year
Date you want this policy to start?*
MM slash DD slash YYYY
How did you hear about First Choice Insurance Group?

Property Address & Mailing Address
Property Address*
Street Address City State ZIP Code
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Ownership Information
Any additional owners listed on the property besides yourself?*
- No
- Yes
Additional Owner(s) Information*
To add additional owners click the "+" sign to the right.
First Name Last Name Date of Birth (mm/dd/yyyy) Relation to Primary
Is the property titled in a name Other Than your personal name(s)?*
i.e. Trust, LLC, Corporation, etc.
- No
- Yes
Name on title of property*
Do you have a mortgage on this property?*
- No
- Yes

Property Information
Any structures on the property?*
(Fence, rock wall, shed, buildings, etc)
- No
- Yes
Please list the structures on this property*
Do you lease the land to anyone?*
- No
- Yes
Any business use?*
- No
- Yes
Please describe the business use*
How many acres?*
or enter the lot size if under 1 acre
How will the property be used?*
(building in the future, business use, leased to others, etc)

Wrapping Up
Would you like a quote from a specific agent?
How were you referred to us?*
Is there anything you want us to know?
Consent*
Like most insurance agencies, [agencyname] uses information from you and other sources, such as your driving and claims histories, insurance score, and other factors to calculate an accurate rate for your insurance. New or updated information may be used to calculate your renewal premium.
I Agree
All the above information is accurate and true to the best of my knowledge.*
- Yes
Would you like to create a user account to manage your submissions?*
- Yes, create my account
- Not at this time
Username*
Password*
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First Name	Last Name	Date of Birth (mm/dd/yyyy)	Relation to Primary

Get a Vacant Land Insurance Quote

Property Address & Mailing Address