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Name of policy holder

Located on your insurance cards or monthly bill.

Add vehicle, add driver, delete vehicle, delete driver, address change, etc...

Tell me exactly what you are wanting to change. If this is a vehicle change (add) provide the vin, add a driver: provide name dob, dl # and violation info, etc...

Please be advised this will be a quote only, all changes require the policy holder to be present in the office at the time of the change and must give a signature to make changes!

Need assistance with this form?

 PLEASE BE ADVISED, THE ABOVE FORM IS FOR ESTIMATES ON POLICY CHANGES ONLY!! CHANGES WILL NOT BE COMPLETED UNLESS THE POLICY HOLDER IS IN OUR OFFICE AND SIGNS FOR THE CHANGE TO BE COMPLETED!!

As the policy holder it is your responsibility to report any changes that need to be made to your policy as soon as they arise; failure to do so could result in possible cancellation, increase in premium; or denial of a claim. 

Some of the more frequent changes that could arise are:

*Vehicle change

*Coverage change

*Additional driver

*New household members (age 14 and older)

*Child received a permit or driver's license

*Need an SR-22

*Most frequent: Address change

 

It is important that you keep all of your information up to date with your Insurance company and your Agent.  If you need to make changes to your policy please stop in our office and we will be happy to assist you.  Or if you are insured through Progressive Drive you may be able to make the necessary changes on their website (please visit their website).

https://www.progressiveagent.com/manage-your-policy.aspx

 

 

 

 

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