Revis E Smith Insurance AgencyQuote Information needed for Auto/Truck/Motorcycle/Boat Quote Information needed for Home-Rental Quote Information needed for Business Quote Information needed for Life or Health Contact UsProducts/History

Quote Information needed for Auto/Truck/Motorcycle/Boat

The best way to receive a quote is to make a copy
of your
current insurance declaration page
and email it to

If you have the time, please provide the
information outlined below to

Be sure to include your email address
on any form that you send.

If you have any questions please
call 972-881-5028 or 214-536-5540.


(If the machine answers, please leave a message.)

 The Vehicle questionnaire has 4 Sections

 Section 1  Personal Information:

  1. Your Name and Email Address
  2. Do you Own Your Home?
  3. Are Vehicles Titled to You?
  4. Home Phone and/or Cell Phone
  5. Street Address
  6. City, State, Zip Code

Section 2  Driver information
  1. Names of Current Licensed Drivers in Your Home
  2. Drivers Dates of Birth
  3. Drivers License Numbers
  4. Drivers Social Security Numbers
  5. Drivers Driving History (Tickets, Accidents)
Section 3  Vehicle information
  1. List of Vehicles including the VIN numbers (Vehicle Indentification Number)
  2. Use of each Vehicle
  3. Annual mileage of each vehicle
  4. Current Odometer (mileage) reading for each vehicle
Section 4  Current insurance information
  1. Current insurance Limits (found on your declaration page)
  2. Current Insurance carrier
  3. Date current insurance expires
  4. Number of years with current insurance company
  5. Discounts offered by current insurance company
  6. Current insurance premiums per month


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