Auto Change Information Form

Auto Dealers: Please submit the following information for our mutual clients to secure the proof of insurance for their new vehicle.¬† We will contact our insured to confirm coverage. Information marked with an asterisk (*) is required on this form and if the information requested does not apply just fill in “none” in that section.¬†Proof of insurance will be emailed or faxed to you upon receipt of this form. We will then contact the insured to confirm coverage and endorse their policy.

Please Note: if the client does not currently have a policy with Harbor/Brenn Insurance, they need to call and secure a quote and policy before we can provide proof of insurance.