Agent Quote 2 IFS Do Not Use if contact already in IFS! Let Gary know of any issues that need to be looked at "(Required)" indicates required fields Name(Required) First Middle Init Last City(Required)Phone(Required)Email Birthdate(Required)Male or Female(Required) Male Female Eng/Spn(Required) Eng Spn Agent(Required) Daisy Kasey Gary Status(Required) Quoted Lost Dead/Spam HawksoftIDSource(Required) 2+ Policy RW-Lapse Former 6m+ Google Facebook Ref-Agent Ref-Client Ref-Dealer Ref-Lawyer Ref-Other StreetSign Other Company Quoted(Required) NatGen Progressive Dairyland Safeco Foremost The General BristolWest Policy Type(Required) Auto Broadform SR22 Motorcycle BF Motorcycle RV Boat Renters Mobilehome Homeowners Landlord Mexico Other Delay Follow-UpOtherwise 1st call back tomorrowCall Note(Required)NameThis field is for validation purposes and should be left unchanged.
