Two ways to do this. Fill it in below and send it to us online — or download the PDF, print it, and send it back. Please also provide a brochure and five years of claim history, if applicable.
Download it, print it, fill it in by hand, and send it back to us.
14752 Beach Blvd Suite 143, La Mirada CA 90638
Mailing address: P O Box 736, La Mirada CA 90637
lillian@bakerromero.com
(626) 332-2258
Monday – Friday 9:00am – 5:00pm
