(972) 931-9285
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Classic Car Insurance Quote
Contact Us
(972) 931-9285
9304 Forest Lane #217
Dallas, TX 75243
Click Here to Email Us
Enter Your Information Here:
*
Indicates required field
Vehicle #1:
Year
*
Make
*
Model
*
Annual Mileage
*
5,000
7,500
10,000
12,500
15,000
20,000
25,000
30,000
40,000
50,000+
Approximate Value
*
Comprehensive Deduct
*
$100
$250
$500
$1000
No Coverage
Collision Deductible
*
$100
$250
$500
$1000
No Coverage
Vehicle #2 (if necessary)
Year (V2)
*
Make (V2)
*
Model (V2)
*
Annual Mileage (V2)
*
5,000
7,500
10,000
12,500
15,000
20,000
25,000
30,000
40,000
50,000+
Approximate Value (V2)
*
Comp Deduct. (V2)
*
$100
$250
$500
$1000
No Coverage
Collision Deduct. (V2)
*
$100
$250
$500
$1000
No Coverage
Driver Information
Primary Driver Name
*
Date of Birth
*
Gender
*
Male
Female
n/a
Age
*
Under 16
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
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47
48
49
50
51-55
56-60
61-65
66-70
71-75
76-80
81-85
86-90
91-95
96-100
100+
Married?
*
Yes
No
Status
*
Employed
Student
Retired
Other
Driver 2 Name (if necessary)
*
Date of Birth (D2)
*
Gender (D2)
*
Male
Female
n/a
Age (D2)
*
Under 16
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
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42
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44
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46
47
48
49
50
51-55
56-60
61-65
66-70
71-75
76-80
81-85
86-90
91-95
96-100
100+
Married? (D2)
*
Yes
No
Status (D2)
*
Employed
Student
Retired
Other
Current or Prior Insurance Company
*
Continuous Coverage
*
Not Currently Insured
Under 6 Months
6 Months
12 Months
1 Year
2 Years
3 Years
3-5 Years
5-10 Years
10+ Years
Claims in 3 Years
*
None
1
2
3
4+
Policy Expires In
*
Not Sure
A few days
2 weeks
1 month
2 months
3 months
3-6 months
6+ months
Tickets in 3 Years
*
None
1
2
3
4
5
6+
Coverage Desired
*
State Minimum
Standard Coverage
Premium Coverage
Name
*
First
Last
Mailing Address
*
Address
*
Line 1
Line 2
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State
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Email
*
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