Auto Policy Endorsement Step 1 of 11 9% What type of change will you be making?Add a vehicleRemove a vehicleAdd a driverRemove a driverChange your mailing addressAdd a lienholderOtherPlease select all that apply. If buying and selling a vehicle at the same time please select "add a vehicle" and "remove a vehicle". What change are you wanting to make? Name of the Person Requesting the ChangePhone NumberEmail Removing a VehicleWhat vehicle are you removing/replacing?Year, make, model, VIN (if known)What day did you sell the vehicle? Date Format: MM slash DD slash YYYY Are there any other details we need to be aware of? Adding a VehicleWhat is the year, make, and model of the vehicle you are adding?What is the VIN of the vehicle you are adding?Should be 17 Characters What day did you purchased/leased the vehicle? Date Format: MM slash DD slash YYYY Did you purchase or lease the vehicle? Purchase Purchased with financing Lease Has the vehicle been modified in anyway? Yes No Please describe the details of the modificationHow will the vehicle be used? Pleasure (includes commute 0-3 mi) Commute to/from work/school (4-14 mi) Commute to/from work/school (15+ mi) Business Occasional Business Farm Please describe how the vehicle will be used in your businessWho will be driving the vehicle?Do you want only liability on the vehicle? Yes No Meaning you do not want comprehensive, collision, rental, or towing Finance Company InformationFinance CompanyName, address, phone, email or fax number if available List which vehicle the finance info is for. Coverage DetailsWhat is your desired collision deductible? 0 100 250 500 1000 What is your desired comprehensive deductible? 0 100 250 500 1000 Which coverage enhancements would you like to include?Full Glass CoverageRental ReimbursementTowingLoan/Lease GAP Coverage Change your mailing addressWhat is your new mailing address?Will this address also be your physical address?YesNoOtherIs this where you will living? Add a DriverHow many drivers will you be adding?12+What is the driver's name? First Last What is the driver's license number?What is the driver's date of birth? Date Format: MM slash DD slash YYYY For the additional drivers please provide - Full Name, Date of Birth, DL #, and state of license.What date would you like to make the change? Date Format: MM slash DD slash YYYY Remove a DriverWhat driver will you be removing? First Last What date would you like to make the change? Date Format: MM slash DD slash YYYY Any other comments or questions?How would you like to us to confirm the change has been made? Call me Text me Email me Coverage Confirmation Required* I understand coverage confirmation is requiredUpon submitting this form I understand coverage is not immediately changed or altered in anyway until receiving written or verbal confirmation from a licensed agent at The American Insurance Group. Name First Last NameThis field is for validation purposes and should be left unchanged.