New Customer Registration Form

Thank you for your response. ✨

Name

Phone

How did you hear about us?

INSURANCE INFORMATION
Please call and confirm with your insurance company that your policy has FULL COVERAGE with the following:
1. Comprehensive and Collision
2. Motorist Coverage — $100K Insured / $300K Uninsured
3. Property Damage — $100K
If not you should be able to upgrade it and once your rental has been returned, you can change your policy back to your original coverage.

Insurance Company

Policy Expiration Date

DRIVER’S LICENSE #

State Issued

License Expiration Date