Policy Change Request

Please enter your information below and our Service Team will help with your existing policy ASAP during business hours.

****Coverage can not be bound using this request. We will notify you once coverage has been added.

Your Name*

First Last

Email - (use your common email address so we can find your policy)*

Phone Number - (mobile number is best for text confirmations)*

Desired Effective date of change*

Which policy do you need help with today?*

How can we help with your homeowners policy today?*

How can we help with your Rental Property policy today?*

Change Mortgage Company
Email me a copy of my current policy
Change My Mailing Address
Other

How can we help with your Business policy today?*

Update Certificate of Insurance
Email me a copy of my current policy
Change My Mailing Address
Other

How can we help with your policy today?*

Update Lender information
Add a vehicle, watercraft, or other
Remove a vehicle, watercraft or other
Email me a copy of my current policy
Change My Mailing Address
Other

How can we help with your Life insurance policy today?*

Email me a copy of my policy
Update/Change Beneficiaries
Change My Mailing Address
Other

Please provide details on which beneficiaries you would like to change or update. Be very specific and include Date of Birth, SSN# and whether the beneficiary will be a Primary or Secondary Beneficiary. If you have more questions, give us a call instead - 940-268-5112

Which Policy would you like us to send to you?

Motorcycle
RV/Travel Trailer
Watercraft/Boat

Please provide the updates you need to your Certificate of Insurance*

Policy Type	Replace or Additional? (current Cert Holder)	New Certificate Holder Name

Which policies would you like us to email you?*

What "Other" business policies do you need us to email you?

Policy

New Mortgage Company:*

Loan Number*

Address (if known)

Please specify the personal property items you would like to add and their $ value

(For example you may need to add jewelry, firearms, or a musical instrument of higher value to your policy)

How can we help with your Auto policy today?*

Lender/Bank information for Car/s*

Lender/Leasing Company Name	Vehicle (Year/Make/Model)

Please provide the Lender information that should show for your vehicle, watercraft, or other*

Lender/Leasing Company Name	Vehicle (Year/Make/Model)

Did you already Trade-In or Sell your CURRENT vehicle to be replaced? (We recommend that you keep your CURRENT vehicle on your policy until you have sold it or transferred ownership.)*

No
Yes

Which CURRENT vehicle (Year/Make/Model) on your auto policy are we removing?*

Which vehicle (Year/Make/Model) on your policy do we need to remove?*

When did you sell, trade-in, or transfer ownership of your CURRENT vehicle?*

When did you sell, trade-in, or transfer ownership of your vehicle, watercraft or other toy?*

What is the Year/Make/Model of the car to be added?*

What is the Year/Make/Model of the vehicle or watercraft to be added?*

What is the VIN, Serial#, or Hull ID?

Please double check your entry to make sure it's correct.

Please attach/upload a photo of the VIN# of the vehicle to be added

Drop files here or

Accepted file types: jpg, gif, png, pdf, jpeg, tif, bmp, Max. file size: 50 MB.

Please Type your VIN here if you can't upload a photo

(after 1981, all cars have a 17 digit VIN number)

When did you purchase this car?*

When did you purchase this vehicle, watercraft or other toy?*

Who will be the primary driver of this newly added car?*

If none, enter "none"

How Will The New Car Be Used?*

Pleasure
Work/School Commute
Business/Commercial

Approximately how many miles will this car be driven annually?*

The average commuter will drive approximately 13,000 miles a year.

Would you like to add Comprehensive and Collision coverage for this vehicle? (Most cars that are financed are required to have comprehensive and collision coverage. We also recommend this coverage if this car will cost more to replace than the amount of cash you have saved to buy another one)*

Yes
No

I confirm that I want liability only on this vehicle without comprehensive and collision coverage. This means that there would be no coverage for this vehicle if I was in an accident that was my fault.*

LIABILITY ONLY COVERAGE

Does your vehicle, watercraft or other toy need "Full Coverage"?*

Yes
No

(Most lenders require you to have comprehensive and collision coverage. We also recommend this coverage if this item will cost more to replace than the amount of cash you have saved to buy another one)

What Comprehensive Deductible Would You Like?*

Comprehensive generally covers things while your car is parked - hail damage, tree falls on your car, theft, vandalism, etc.

What Collision Deductible Would You Like?*

NOTE: To get a lower premium, you'll want to select a higher deductible.

What Deductible Would You Like?*

NOTE: To get a lower premium, you'll want to select a higher deductible.

Is there a loan or lease on the new car?*

No
Yes

Is there a loan or lease for this toy?*

No
Yes

Name of Lender or Leasing Company*

Which Car/s Are You Removing? (Year/Make/Model)

Reason For Removal?*

Sold
Car is not being driven or broken down and I'm okay without having any insurance on the car. (We recommend taping a piece of paper on the steering wheel reminding you that this car is uninsured until you start driving it again)

When did you sell or transfer ownership of this vehicle?*

(We recommend that you keep your vehicle insured on your policy until you have sold it or transferred ownership.)

When do you want to add this New Driver?

As soon as possible
Pick a date in the future

Date*

New driver - First and Last Name*

New driver - Date Of Birth*

New driver - Job title/Industry*

New driver - Driver's License# and State Licensed*

New Driver - Relation To You*

Is the new driver a current high school student with a 3.0 or better GPA?*

Yes
No

If the new driver is a high school student with a 3.0 or better GPA, they will qualify for a "good student discount". You will need to submit proof (last report card) to info@texasautohome.com.

Name Of Driver You Are Removing?*

When would you like to Remove this Driver?

As soon as possible
Pick a date

Date*

Is This Person Still A Household Resident?*

Yes
No

New Mailing Address:*

(please include Apt or Suite # if applicable)

Please Specify Your "Other" Changes. Be As Specific As Possible*

Please specify how we can help with your "Other"policy.*

Please let us know if there is any additional information you'd like to pass along to the Service Team to help complete your request:

Please enter your information below and our Service Team will help with your existing policy ASAP during business hours.

****Coverage can not be bound using this request. We will notify you once coverage has been added.

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