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Copyright © 2007-10 A.F. Szabo Insurance Agency, Inc.
Site designed by Brother4Him Design Studio LLC.

Add A Vehicle

Contact Information:

Current Auto Policy Number:  
Name on Policy:  
Full Name:  
Email Address:  
Daytime Telephone Number:  

New Vehicle Information:
 
Effective Date of Policy Change:  
VIN #:  
Year of Vehicle:  
Make of Vehicle:  
Model of Vehicle:  
Is this a purchase or lease:   Purchase       Lease  
Body Type of New Vehicle:  
Title Holder/Register Owner:  
Name of Principal Driver:  
Principal Driver's Relationship to Named Insured:  
Occasional Driver/Operator:  
Purchase Price:  
Lien Holder/Loss Payee Name:  
Lien Holder Address:  
Garage Address:  

New Vehicle Desired Coverage:
 
Vehicle Usage: (describe)  
Miles to Work: (one way)  
Deductibles: Comprehensive                  Collision 
Anti-Lock Brakes:  
Car Alarm:  
Air Bags:  
Rental Coverage:  
Towing Coverage:  
Additional Comments:  
 
Please Note:
Insurance coverage cannot be bound without a written binder from our office.

 

 

A.F. Szabo Insurance Agency, Inc.
11705 Berry Rd. Suite 101
Waldorf, MD 20603
Office: 301-645-8545 - 1-800-828-3645
Fax: 301-645-0912

 


Hours of Operation:

Monday through Thursday 8:00Am to 4:30PM Friday 8:00am to 2:00PM

 

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Change of Name - Change of Address - Request Certificate of Insurance - Add or Delete Loss Payee/Mortgagee - Property Policy Change 
Request Auto ID Cards -
Add a Vehicle Form - Remove a Vehicle from Existing Policy - Replace a Vehicle on Existing Policy

 

 

 

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