| INFORMATION TO SEND FOR QUOTE
Name:
Address:
Zip Code:
Date Of Birth:
Social Security#: (not necessary, but does give more accurate quotes if provided)
Drivers License#:
Vehicle(s) Year/Make/Model:
Deductible: $500 or $1000
Contact#:
-Have you taken defensive driving in the past three years?:
-How many tickets/accidents do you have in the past three years ON YOUR RECORD?:
-How much do you currently pay? And which insurance company is it with?
-Did you recently purchase this vehicle?
-Is the vehicle titled to your name?
-Are you married?
-Do you have any children?
-Do you have health insurance?
-Have you been driving un-insured for more than 30 days?
-Have you had your drivers’ license for the past three years?
-Do you have any DWI's or suspended licenses in the past three years?
-Do you have your motorcycle license?
Please Note: If you absolutely have a total of three violations such as at fault tickets or traffic tickets on your record that total to 3, we cannot write a policy for you at all and you do not qualify for state farm.
PLEASE DO NOT ANSWER THESE QUESTION ON MY COMMENT BOX, PLEASE SENT AN EMAIL OR AIM.
EMAIL: HIEN.TRAN.PX5V@STATEFARM.COM
CELL: 281-686-0380
AIM: STATEFARMTOMMY
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| America's #1 Auto Insurer!
State Farm® has been in the business of providing excellent
automobile coverage at an affordable price since 1922. Responding to
our customers' needs keeps us the leader in auto insurance.
 Agent: Tommy Tran
Cell: 281-686-0380
AIM: Statefarmtommy
Email: hien.tran.px5v@statefarm.com
Location: bellaire and belway 8
"I can quote you a cheaper rate with a better company"
WE DO LIFE, HEALTH, AUTO, MOTORCYCLE, AND HOME INSURANCE
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The New Year Cookie
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