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Atlas Insurance Brokers
Mark Stangler Agency

 

Bus: 952.469.1814  

Fax: 952.516.5445

Toll Free: 800.313.0594  

 

8353 210th St W
 Lakeville, MN 55044 

Map to our office

 

email: mark@markstangleragency.com

Minnesota License # IN-20352490

Wisconsin License # 2501574

Arizona License # 916953

Iowa License # 7470001

 

 

 
 
 
 
Homeowners Insurance
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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:

Please enter additional notes below: