Add a New Vehicle

Add a New Vehicle to My Auto Policy
* Required
Full Name:
(Your name as it appears on your policy)
Your answer
Phone Number: *
Your answer
Email Address: *
Your answer
Date/time you took possession of your new vehicle: *
MM
/
DD
/
YYYY
Time
:
AM
PM
Year, Make & Model of the new vehicle: *
(Example: 2015 Ford Fusion)
Your answer
Vehicle Identification Number (VIN): *
(17 digits long, consisting of both letters and numbers.)
Your answer
Is there a loan or lease on this vehicle? *
Choose
Loan
Lease
No loan or lease
If yes to loan or lease, list the name & address of the lien holder:
(Example: General Electric Credit Union 10485 Reading Rd. Cincinnati, OH 45241)
Your answer
If you sold or traded-in a vehicle, list Year, Make, Model below:
(Example: 2005 Ford Taurus)
Your answer
Who will be the primary driver of this new vehicle? *
(If you need to add a new Driver, complete this form and follow instructions provided.)
Your answer
Notes or Special Instructions:
Your answer
Submitting this information IS NOT a Policy or Binder of Insurance. No coverage will be bound until you receive confirmation from us.
BY CLICKING THE "SUBMIT" BUTTON BELOW, I CERTIFY THAT THERE IS NO PRE-EXISTING CLAIM, LOSS OR CIRCUMSTANCE LIKELY TO LEAD TO SUCH A CLAIM OR LOSS FOR WHICH I AM APPLYING FOR COVERAGE.
WARNING: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR ANOTHER PERSON FILES AN APPLICATION FOR INSURANCE CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON TO CRIMINAL AND [NY: SUBSTANTIAL] CIVIL PENALTIES. IN TN, VA AND WA, INSURANCE BENEFITS MAY ALSO BE DENIED.
NOTICE TO OHIO APPLICANTS: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING HE/SHE IS FACILITATING A FRAUD AGAINST AN INSURER, SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD.

Questions? Contact:
Cameron A. Shandersky, CPCU
Schiff Insurance
P.O. Box 145496
Cincinnati, OH 45250-5496
P: 513.870.2580
cameron_shandersky@schiffinsurance.com
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About Author

Cameron A. Shandersky, CPCU
Cameron's Bio