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Emily Baugher Insurance | insurance mn, life insurance mn, business liability insurance, small business insurance minnesota, cheap auto insurance mn, sr22 insurance mn, cheap car insurance mn, auto insurance quote, home insurance quote, life insurance quote,

Emily Baugher Insurance
A FARMERS UNION AGENCY

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Fill out the form below to get your customized insurance quote. The form may expand based on your answers. If you don't know or are unsure of any of the answers, it is ok to leave them blank.

If you just want to contact us or have one of our agents reach out to you, please use the Contact Us page.

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Home

Auto

Recreation

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Umbrella

Home Information

Own/Purchase/Build/Rent

Type of residence

Current Home Insurance Carrier

Continous Years of Coverage

Purchase/Closing/Move In Date

Same as Address Above

New Street Address

City

State

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Vehicle Information

Vehicle Make

Vehicle 2 Make

Vehicle Model

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Continuous Years of Coverage

Continous Years of Coverage

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Continous Years of Coverage

Continous Years of Coverage

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Recreational Vehicles

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Year

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Purchased in the last 90 days?

Yes

No

Purchased in the last 90 days?

Yes

No

Purchase Price

Purchase Price

Boat Motor Make

Boat Motor Make

Boat Motor Model

Boat Motor Model

Boat Motor Serial Number

Boat Motor Serial Number

Boat Motor Year

Boat Motor Year

Insure Trailer with Boat?

Yes

No

Insure Trailer with Boat?

Yes

No

Trailer Description

Trailer Description

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3rd Rec Vehicle

3rd Rec Vehicle Make

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Purchased in the last 90 days?

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No

4th Rec Vehicle

4th Rec Vehicle Make

4th Rec Vehicle Model

4th Rec Vehicle Year

VIN/Serial Number/Hull ID

Purchased in the last 90 days?

Yes

No

Purchase Price

Boat Motor Make

Boat Motor Model

Boat Motor Serial Number

Boat Motor Year

Insure Trailer with Boat?

Yes

No

Purchase Price

Boat Motor Make

Boat Motor Model

Boat Motor Serial Number

Boat Motor Year

Insure Trailer with Boat?

Yes

No

Trailer Description

Trailer Description

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Business Information

Business Name

Street Address

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State

Zip Code

Farm Information

Interested Farm Coverage(s)

Home

Barn/Outbuilding

Equipment

Farm Liability

Multi-Peril (MPCI)

Crop-Hail

Other

Type of Operation

Grain & Livestock

Confinement Operations

Equine Business Operations

Farmers Market Exposures

Farm to Table

U-pick Operations

Agri-tainment/Agri-tourism

Custom Harvesting

Spraying Operations

Other

Health Information

Type of Coverage

Business Name

Street Address

City

State

Zip Code

Enrollmet Period

Open Enrollment Period - November 1 - December 15. Effective January 1 of next year.

Special Enrollment Period - due to a Qualifying Life Event.

Current Coverage

Current Insurance Carrier

Primary Applicant Income (for tax credit purposes)

Employer

Anticipated End Date

Spouse Income (for tax credit purposes)

Is anyone ele in the household offered coverage through an employer?

Yes

No

Brief description of your situation and when you need coverage.

The following questions will help us find a Medicare plan that best fits your needs.

Preferred Pharmacy

Hospital

Pharmacy Location

Clinic

Do you reside in an assited living, long-term care or skilled nursin facility?

Yes

No

Do you have End State Renal Disease?

Yes

No

Are you a Snowbird?

Yes

No

Where do you travel?

Are you planning to make a permanent move in the near future?

Yes

No

Where do you plan to move?

How many medications are you currently taking? Not including vitamins & supplements.

Medication 1

Medication 2

Medication 3

Medication 4

Medication 5

Dosage/Strength

Dosage/Strength

Dosage/Strength

Dosage/Strength

Dosage/Strength

Life Information

Height

Weight

Health Condition

Tobacco Usage

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109 2nd St NE
Roseau, MN 56751

218-463-2369
emilyb@fuainsurance.com

Licensed In:
Minnesota
North Dakota
North Carolina

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Home
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Farm & Crop
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F U A

Farmers Union Agency

Get in Touch

Contact Us

218-463-2369

Emily: emilyb@fuainsurance.com

Erica: erica@fuainsurance.com

Steve: steve@fuainsurance.com

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Location

109 2nd St NE
Roseau MN 56751

Hours:

Monday - Friday
9:00 am - 5:00 pm

Saturdays by appointment

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Trusted. Independent. Local.

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