Billmark's Lakes Area Insurance : Auto Insurance Change or Inquiry

Billmark's Lakes Area Insurance, Inc. • 320-763-9022 • 888-763-9022



		Billmark's Lakes Area Insurance Inc. 913 Broadway Street Alexandria MN 56308 888-763-9022 toll free 320-763-9022 phone 320-763-3548 fax



		Lakes Area Insurance 105 Central PO Box 567 Brandon MN 56315 320-524-2525 phone 320-834-2409 fax

Disclaimer: Coverage is not binding until you receive a confirmation call from our agency. If you do not hear from us within one business day of your request, please call us at 320-763-9022 or toll free at 888-763-9022.
GENERAL INFORMATION
Request for: Change Inquiry Effective Date:
Policy Number:
Your Name:
Email:
Day-time Phone:
Fax:
How to Proceed?: Call me to discuss my Policy See Below Information
DELETE A VEHICLE
Year:
Make/Model:
Reason: Sold Stored Traded Other
ADD A VEHICLE
Year:
Make/Model:
Comprehensible Deduction: $100 $250 $500 $1000
Full Glass Coverage: Yes No
Collision Deduction: $100 $250 $500 $1000
Roadside Assistance: Yes No
Rental Vehicle: Yes No
Loan/Lease Payoff: Yes No
VIN #:
Owner:
Primary Driver:
Describe Use:
Anti-Lock Brakes: Yes No
Anti-Theft Alarm: Yes No
Airbags: 1 2 None
Interest, If any: Bank Loan Leaseholder None Other
ADDITIONAL REMARKS/COMMENTS: