Farm and Ranch Owners Application Completed Form Examples and Samples

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Completed Farm and Ranch Owners Application for a Texas cattle ranch and hay operation owned by Wade Hollister

Source document used: Insurance Agent Field Notes / Client Intake Summary

Client Intake Notes – Wade Hollister Ranch
Date of Visit: May 8, 2026
Prepared by: Travis Engel, Producer
Agency: Lone Star Agricultural Insurance, Agency Code: LSA-00412
Phone: (979) 555-0183 | Email: [email protected] | Fax: (979) 555-0199

I visited the Hollister property this morning. Wade Hollister (DOB: 03/14/1971) operates a cow-calf beef cattle ranch and hay production operation out in Wharton County, Texas. He's an individual owner — no partnership or corporate structure. His FEIN is 74-2981035. His mailing address is 4820 County Road 257, El Campo, TX 77437. Phone is (979) 555-0244. No web address on file.

Primary location is 1,840 acres outside city limits at 4820 County Road 257, El Campo, TX 77437, Wharton County. The nearest fire station is a volunteer station about 9 miles away. He is NOT renting or leasing this land to anyone else.

He also has a second parcel — 320 acres at 1105 FM 2856, Louise, TX 77455 — about 3 miles from the town of Louise, heading north. No buildings on that parcel, and it's not rented to others. The operation started in 2003. He currently runs approximately 280 head of cattle and keeps 8 horses on the main place.

Type of operation: cow-calf beef cattle and coastal bermuda hay production.

Wade's primary residence is located on the main property. It's a 2003-built frame construction home, 2,200 sq ft, single story, asphalt shingle roof about 6 years old, enclosed foundation, central heat and AC. There are 4 smoke detectors inside. ADT monitored alarm system. We want Replacement Cost on both dwelling and contents, Special perils, $2,500 deductible, 2% wind/hail deductible. Dwelling limit: $425,000. Other structures: $42,500. Personal property: $85,000. Loss of use: $42,500. Not used as VRBO/Airbnb. Primary residence: yes. No updates needed — house is only 23 years old.

For the main barn (Location 1), it's a frame construction equipment and cattle barn, built 2001, roughly 4,800 sq ft, metal roof about 12 years old, no open sides, used for hay storage as well. Limit $180,000, $2,500 deductible, Broad perils. GPS approximately 29.1832° N, 96.2741° W.

Equipment to schedule:
1. 2019 John Deere 8370R tractor, serial #1RW8370RXKP123456, Location 1. Limit $185,000. $2,500 deductible. Standard farm equipment.
2. 2021 Vermeer R2300 hay rake, serial #VMR2300X21-78432, Location 1. Limit $28,000. $1,000 deductible. Standard farm equipment.

Miscellaneous farm equipment blanket limit: $45,000. $2,500 deductible. Broad perils.

Scheduled livestock: 280 head of beef cattle, $1,800 per head value. $2,500 deductible. Broad perils.

Hay in structures limit: $30,000. Hay in open: $10,000. $1,000 deductible.

Coverages requested: A (dwelling), C (personal property), E (equipment/livestock/hay), G (barns), H/I liability with $1,000,000 occurrence limit, double occurrence for aggregate. Coverage J medical payments at $5,000 per person.

Additional insured: First National Bank of El Campo, mortgage on primary residence. Address: 201 N. Mechanic St., El Campo, TX 77437. Loan #FNB-2019-4471.

Wade has one prior loss — a hail claim on the barn roof from June 2022, paid out $14,500.

Livestock are all fenced. Two dogs on premises — a border collie and a blue heeler, no prior claims. No trampolines, no swimming pool, no ATVs on premises. No agritainment. No exotic wildlife. No public farm operations. Fire extinguishers on site. No flood plain buildings.

Two seasonal workers hired at hay harvest — certificates of workers comp required. Payroll approximately $18,000. No housing provided for workers.

Agent last saw the property: May 8, 2026.

Prior carrier: Texas Farm Bureau. Expiring premium approximately $6,200. Policy expiration: June 1, 2026.
Coverage effective date requested: June 1, 2026. Date purchased: May 8, 2026.
Billing: Direct Bill, 4-Pay plan.
Applicant is married.
Agriculture is applicant's primary occupation.
New business to agency: Yes.
Farmed by owner.
Known applicant for 0 years (new client).
No prior cancellations. No other BSW policies.