Get a Quote

To receive a free quote for auto or home insurance, email the information below to and we'll get back to you right away with a competitive quote. **Quote is based on various factors that may change based on those factors. We'll contact you for more details and questions if needed.

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Phone Number:*



Zip Code:*


Auto Insurance

Click here for a free auto quote:
Or complete the information below and email as instructed above:

Current Insurance Company:

Name & Date of Birth of All Household Drivers:

Year, Make and Model of Vehicle(s):

Primary Use of Vehicle: Personal or Business; To/From Work or School or Pleasure

Estimated Miles per Day:            Estimated Miles per Year:

Vehicle 2 if Applicable        

(Vehicle 2 if applicable) Year, Make and Model of Vehicle:

Primary Use of Vehicle 2: Personal or Business; To/From Work or School or Pleasure

Estimated Miles per Day (Vehicle 2):        Estimated Miles per Year (Vehicle 2):

Household accidents/violations in past 5 years: Please include driver, date, type (at fault accident, not at fault accident, or violation)

Home Insurance

Current Insurance Company:

Property Type: Home;Condo; or Renters

Year Built:

Number of Stories: 3, 2, 1.5, 1, Tri-Level, or Bi-Level

Property Type: Standard, Luxury, or Mobile Home

Exterior Wall: At least 50% brick, All brick, Stucco, or Wood frame with vinyl or aluminum siding

Attached Garage: Yes or No

Basement:Yes or No

Home Security System: Yes or No

Roof Type: Asphalt composition (most common), Wood shake or treated wood slats, Metal, Flat roof

Square Footage:

Number of Bedrooms:

Number of Baths:

Claims/Losses past 5 years: (please include type of loss and approximate amount of loss)

Life Insurance

call 812-589-7618 or email

Health Insurance

call 812-589-7618 or email

Jason Wright Insurance Agency LLC
417 North Weinbach Avenue, Suite 104
Evansville, IN 47711
We are licensed to do business in the following states: Indiana and Kentucky.
Providing Insurance for the Evansville, Indiana and Henderson, Kentucky area.