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Farm Insurance

Name:
Address:
City:
Province:
Postal Code:
Phone Number:
E-mail Address:
Type of Farm:	-select- Beef Cash Crop Combination Dairy Hobby Hog Horse Poultry Sheep Other
Type of farm (if not listed above):
Location
Lot:
Concession:
Township:
Acreage:
Total building value:
Claims - Past 3 years: