Change Policy Request

Policy Change Request

**By Minnesota law your policy change is not bound until you speak with one of our agents. We'll get in touch with you, shortly** We CANNOT cancel a policy until we receive a signed request to cancel from the insured.

Please complete the form below:

Full Name	*
Policy Number	*
Insurance Company	*
Phone Number	*
Email Address	*
Describe the policy change you'd like to make. If adding a vehicle, please list Year, Make and Model of Vehicle	*
VIN of new vehicle, if applicable
What coverage do you need on your vehicle, full coverage or liability? Please call if you have questions about coverage.	*
Do you have a loan on the car? Please list name and address of lienholder (Ex: bank's name and address)	*
Special needs or comments regarding policy change