Mortality Quote Request | LB Farm and Equine I

Request a Mortality Quote

First & Last Name (s) of insured.

Street Address

City, State & Zip

Phone

First Horse

Horse's Name

Use or Discipline of the horse. Add level of training

Breed

Date of birth

Purchase Price

Purchase Date

Purchased from:

Horse's Height & Color

How much time is your horse stalled and turned out?

Current Value

Permanent location of horse.

If your horse goes to a trainer, please list name, address & phone number, rate per month & # of months in training for the past 12 months

How has your horse increased in value?

Foal Valuation

Good, bad or ugly.. Provide details not covered on this form? Has there been colic, EPM, Lameness, Lymes etc.

Vet's Name & Contact

How healthy is your horse? What do we need to know?

Second Horse

#2 Horse's Name

#2 Horse - Use or Discipline of the horse. Add level of training

#2 Horse - Breed

#2 Horse - Date of birth

#2 Horse - Purchase Price

#2 Horse - Purchase Date

#2 Horse - Purchased from:

#2 Horse - Current Value

#2 Horse - Horse's Height & Color

#2 Horse - How much time is your horse stalled and turned out?

# 2 Horse - Permanent location of horse.

# 2 Horse - If your horse goes to a trainer, please list name, address & phone number

#2 Horse - Training details

#2 How has this horse increased in value?

# Horse - Foal Valuation

#2 Horse - Good, Bad or Ugly - Tell us everything

#2 Horse - Vet's Name & Contact

#2 Horse - How healthy is your horse? What do we need to know?

HORSES: More info

If you have more than 2 horses, either fill in their information below or fill out this form again and submit for every two horses

Please upload:
Registration papers
Vet exams
Purchase agreement or bill of sale
Lease agreement

Upload File

Thank you. We will be in touch in a business day or two.

Request a Mortality Quote

First Horse

Second Horse

Please upload: Registration papers Vet exams Purchase agreement or bill of sale Lease agreement

Please upload:
Registration papers
Vet exams
Purchase agreement or bill of sale
Lease agreement