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Phone Numbers:

  • (949) 270-0609
  • (352) 404-4445

 

 

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DUI AUTO INSURANCE QUOTE REQUEST

SR22 or FR44 Filing Quote Request

Use this form for All States

Click Here for Non-Owner Insurance Quotes

ABOUT THE DRIVER

First Name:
Last Name:
Address:
City:
State:
Zip Code:
Phone:    
Birthday:   (dd/mm/yy)
E-mail:
Confirm E-mail:
Home Status:
Gender:
VIN (if available): (17 digits)
  Where can I find my VIN? (pop-up)
Drivers License:  
Social Sec Num (Optional for more accurate quote; not used in California)  
Status Single   Married  Widowed   
   
SR22 / FR44:
   
When do you plan to start this insurance? (month/day/year) 
   
Education Level:  
   
Most Recent DUI / DWI (if any):
   
Is there another car in your household?

Second Driver (if none, scroll down)

First Name:
Last Name:
Birthday:
Drivers License:

ABOUT THE AUTOMOBILE

Year: Doors:
Make:
Model:
Version:  (LT, EX, LTD, extend cab, 4x4, 4x2, etc)
4x4:
If truck: Cab Style
Engine: Number of liters (1.2, 2.0, 2.5, 3.0, etc)
Antitheft:
Airbag(s): None Driver Only Driver and Passenger  
   

COVERAGE OPTIONS

Liability Limits:
Uninsured Motorist:
   
Medical Payments:
   
Coverage Types:
   
Deductibles: Collision:

Comprehensive:

   
How long have you been with your most recent insurance carrier:

 

Which Company?  

Length of Current Coverage (IF ANY):

   
How much insurance did you have with your last carrier?
   
Discounts:
More Discounts:
   
Referral: If someone referred you, please let us know:
   
   
   
Florida Only:
Tickets/Accidents:  

Please tell us if you have any tickets, DUIs,  and at-fault accidents. List the dates, types, and if available, violation number. Please be as specific as possible. We will go over this with you when we provide the quote.

 
   
Other Quote Options:
   
  Do you have any additional information, special coverage needs or questions to ask? If you have any other individuals of legal driving age in your house, please let us know here.  Most companies require that you include or exclude all of the other potential drives that live in your home.
 
   
  Did you complete your birthday and zip code? These are crucial to us obtaining an accurate quote. Thank you.
 
 
 

 

 

Click Here for Non-Owner Insurance Quotes

We can often help if you have a DUI / DWI, multiple points, accidents, a suspended, or foreign driver's license.  We will work hard to find you a competitive rate and to provide you with excellent service

 

An SR-22 Filing is a form issued by an insurance company, which removes a suspension order placed by the DMV on your driving privilege. The filing provides a guarantee to the Department of Motor Vehicles that an insurance company has issued at least minimum liability coverage for the person making that filing; AND  that the insurance company will notify the DMV should the insurance ever lapse for any reason.

An FR44 Insurance Filing is similar except that it guarantees that you have specific liability limits as required by the DMVs in certain states.

 

Same Day Quotes and Filings Available in most cases

 

 

 

 

If you are not sure of exactly what you need, make sure to at least give us a description of your vehicle and we will send you a base quote that we can later adjust to find what is right for you.

 

 

 

Need help?

(949) 270-0609

 

If you have more than one car, please tell us about the second car in the additional information section.

 

 

 

 

DISCOUNTS

Some of the insurance carriers give discounts to clients that belong to certain organizations, have certain professions, or have mortgages with specific companies.  If you think that you might qualify for such a discount, let us know.

 

Most insurance companies use information from you and other sources, such as your driving, claims, CLUE report and credit histories, to calculate an accurate price for your insurance. We will take the information that you provide here and use it to obtain a quote. New or updated information may be used to calculate your renewal premium. Its Privacy Policy explains how each company discloses and protects your personal information and how you may access and correct it. We can provide a copy at your request. Credit rating is not used in California.

NO COVERAGE IS BOUND, OFFERED, ISSUED THROUGH THIS ELECTRONIC COMMUNICATION, ALL POLICIES MUST BE UNDERWRITTEN AND APPROVED BY THE CARRIER. DO NOT CANCEL YOUR CURRENT INSURANCE.

   
 

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