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Checklist for Filling out a Private Passenger Auto Application

The following list is provided to help you complete the essential components of the application. Any other missing information will be obtained by a phone call to the producer/agent or insured. Current motor vehicle records for all drivers and any not at fault police reports should be included with application.
  1. Producer/Agency name, address, phone number, agent’s National Producer Number (NPN) and the Federal Employer Identification Number (FEIN).
  2. Applicant name, address, occupation, and phone number.
  3. Description of all vehicles and vehicle use.
  4. Requested coverage/limits.
  5. Complete driver information.
  6. Complete policy number, termination date, and reason for termination from the prior company.
  7. Complete areas regarding accident and violation information.
  8. Producer's signature and date.
  9. Applicant's signature and date.
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