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Buy a new car? New address?

We've made it easy & convenient to

UPDATE YOUR INSURANCE POLICY!

Which Policy Do You Need To Service?*
- Home Policy
- Auto Policy

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

Who should receiving the bills for your insurance premium?*
- Bill to this Mortgage Lender
- Send Bill Directly to Me

Please Specify The Items Needing Coverage And Their Individual Values

New Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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
- Change Deductible
- Other

Your Name*
First Last

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

Reason For Removal?*
- Sold
- Non Operational (this option will require proof of filing Non-Op with the DMV)

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

How long has this driver been licensed?*

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 student with a 3.0 or better GPA and is full-time or carrying a minimum of 12 units, they may qualify for a good student discount. You will need to submit proof (last report card) to service@hershfieldins.com.

Name Of Driver You Are Removing?*

Is This Person Still A Household Resident?*
- Yes
- No

Bank Name*

Which Vehicle Is This For?*

New Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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 A New Car To Me)

Have you already purchased the car?*
- Yes, it’s been purchased. NOTE: Hershfield will be updating your existing auto policy which may result in a change in your premium
- No, I am planning to purchase this car.

Please visit our quote page for a quote.

Which Of Your Vehicles Are Re Replacing With The New Car? (Yr/Make Model?*

How Will The New Car Be Used?*
- Pleasure
- Work/School Commute
- Business/Commercial (Select this option if you occasionally drive clients in your car. Example: Realtor)

How Many Miles Will This Car Be Driven Annually?*

The CA DMV says the average commuter will drive approximately 13,000 miles a year.

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

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

What Is The Odometer Of Your New Car?*

What Was The Purchase Date?*

Check the coverage options you would like:*
- Comprehensive
- Comprehensive & Collision (Necessary if your car is financed or leased)
- Liability only

What Comprehensive Deductible Would You Like?*
- Match my current deductible
- $250
- $500
- $1000
Comprehensive covers everything other than an at fault accident. Ex. Theft, vandalism, a rock cracking your windshield on the freeway, etc.

What Collision Deductible Would You Like?*
- $100
- $250
- $500
- $1000
NOTE: The lower the deductible, the higher the premium.

Is your car:*
- Leased
- Owned – No payments
- Owned – Financed and making car payments

What vehicle does this deductible change pertain to? (Make & Model)*

Is There A Lien Holder? If So, Who?*

If none, enter "none"

Lien Holder Address*
Street Address Address Line 2 City State ZIP Code

Lien Holder Name
First Last

Lien Holder Address*
Street Address Address Line 2 City State ZIP Code

Who Is The Primary Driver?*

If none, enter "none"

Mobile Number*

Email*

Our job isn’t selling insurance, it’s taking care of you and your family.

At Hershfield, YOU are the priority, not the company’s bottom line.

Whether it’s during a claim or even a sudden rate increase, as a broker Hershfield has the unique ability to represent YOUR needs.

PEOPLE are at the heart of our business, not the insurance company.

And that’s the Hershfield difference.

Looking for our main website?

Did you know we have an app?

Check your policy, print documentation, & more right from your phone!

Click the button below and you’ll receive a text to download the app!

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*Message charges may apply based on your carrier and plan.

Hershfield Insurance Agency | 4909 LakewooD Bl Suite 501, lakewood CA 90712 US

+1.866.996.9760 phone | +1.866.996.9761 fax | INFO@HERSHFIELDINS.COM