Personal Insurance Policy Change

Your Name

First Name Last Name

Email

Phone

Which Policy Do You Need To Change?

Auto Policy

Home Policy

Boat Policy

Other

Please Select The Home Changes You Need To Make

Change Mortgage Company

Add More Personal Property Coveage

Change Your Mailing Address

Other

New Mortgage Company

Mortage Company Name and Street Address Loan Number City State ZIP Code

Please Specify The Items Needing Coverage And Their Individual Values

New Mailing Address

Street Address Address Line 2 City State ZIP Code

Please Specify Your "Other" Changes. Be As Specific As Possible

Please Select The Changes You Need To Make

Add Or Replace A Car

Remove A Car

Add A Driver

Remove A Driver

Add A Lienholder

Change Your Mailing Address

Other

Which Car Are You Removing? (Yr, Make, Model)

Reason For Removal?

Sold

Dead

Other

Why are we removing it?

When Did You Get Rid Of The Car? (Specific Date)

New Driver Full Name

New Driver Date Of Birth

New Driver DL#

New Driver Relation To You

New Driver's Employer or School

Current High School Student With A 3.0 or Better GPA?

Yes

No

If the new driver is a high school student with a 3.0 or better GPA, they will qualify for a "good student discount". You will need to submit proof (last report card) to hello@shineinsurance.com

Name Of Driver You Are Removing?

Is This Person Still A Household Resident?

Yes

No

Insurance companies don't let us remove drivers that still live in your home. Please explain the scenario so we can share with the company.

Bank Name

Which Vehicle Is This For?

New Mailing Address

Street Address Address Line 2 City State ZIP Code

Please Specify Your "Other" Changes. Be As Specific As Possible

Is This New Car Replacing Another Car?

Yes (Replace A Current Car With A Different Car)

No (This Is New Car To Me)

Which Of Your Vehicles Is Being Replacing With The New Car? (Yr/Make Model?

What is the New Car? (Yr/ Make/ Model)?

What Is The 17 Character VIN# Of Your New Car?

Please double check your entry to make sure it's correct.

How Will The New Car Be Used?

Pleasure

Work/School Commute

Business/Commercial

How Many Miles Will This Car Be Driven Annually?

An average commuter will drive approximately 13,000 miles a year.

What Was The Purchase Date?

Should we use the same coverage limits as your other cars?

Yes

No

Is There A Lien Holder? If So, Who?

If none, enter "none"

Who Is The Primary Driver?

If none, enter "none"

Year, Make, & Model of the boat

Boat Hull Number

What type of Motor?

Inboard

In/Out

Outboard

Year, Make, Model, & Horse Power of Motor

Horsepower of the motor?

Year, Make, Model of the Trailer

VIN of the Trailer

What is the purchase price?

Where will you store it in the winter

Please Specify Your "Other" Changes. Be As Specific As Possible

Any other Information you need to share?

Add any supporting files here:

Max. file size: 300 MB.

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Request a personal insurance policy change.