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Manjoe Staff

Motorcycle Quote Form

Fields marked with asterisks (**) are required.

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FAQ's
Following are a few questions and answers which are often asked that we hope will be helpful....

Claims
When a claim is filed with the insurance company for damages as a result of an automobile accident...

Terms
Accident is sudden event or happening and is unplanned. A sudden and unexpected,unforeseen event ....

Why its Needed
The use of Automobiles in the United States has created the need for Insurance Coverage to protect the owner....

Understanding Auto
"Liability" coverage is the coverage that protects the owner of the vehicle who has caused the damages....

The Basics
Life Insurance is sometimes never thought about until one experiences a death of a loved one....

Estate Planning
There are many good reasons to plan for an estate. The obvious one is to provide for the orderly disposition....

FAQ's
Following are a few questions and answers which are often asked about Life Insurance ....

Terms
401 K is a Tax Qualified Savings Plan that is a type of profit sharing or stock bonus established by employers....

Life Insurance Articles

Retirement
Retirement plans have been developed to adequately provide for someone to build additional cash for retirement...

Claims
Homeowner claims are paid in several different formats. If your property is damaged and needs repairs...

Homeowner Insurance Articles

Terms
Actual Cash Valies is the replacement cost of the property less any deduction for depreciation due to wear and tear or obsolescence....

FAQ's
Following are a few questions and answers which are often asked about insurance coverage....

Exclusions
The following are typical Exclusions in most Homeowners Policies...

What is Needed?
Along with the homes that we purchase, we have all of our personal furnishings inside of the home....

Drivers History

Please fill out the information for the cycle #1 and person that drives that cycle the majority of the time under Driver #1 below.

To help answer the questions regarding the cycle sections following it will be useful to understand the terms.
Collision
Physical Damage coverage of covered cycles for damage caused from a collision with a vehicle or object.
Comprehensive
Physical Damage coverage for insured cycles which covers all risk other than those perils excluded or are included in collision.
Deductible
Refers to the amount you must pay prior to coverage.
VIN
For motorcycles, the vehicle identification number is found on the vehicle frame, and is listed on the registration and title. The number is a combination of letters and numbers from 10 to 17 characters in length that can be used to identify the make, model, and year of your motorcycle. For Segway HT's, the serial number is located under the mat on the rear edge of the platform. For golf carts, the location of the serial number may vary, but is usually located on the frame.

Motorcycle #1 Information

Driver of Motorcycle #2 Information

Please place a check next to additional coverages for this vehicle below. Note adding coverage will increase your insurance premium.

Driver of Motorcycle #1 Information

General Information

Please fill out the general information, providing us with the means to deliver the quote. Note: Policy Holder(s) must be those persons holding the title or Lease agreement of the cycle(s) to be covered.

Please fill out the information for the motorcycle #2 and person that drives that vehicle the majority of the time Driver #2 below.

Motorcycle #2 Information

Motorcycle and Driver combination #1 Information

Motorcycle and Driver combination #2 Information

Motorcycle #2 VIN:

Motorcycle #2 Model (ex. interceptor, megamoto):

^** Primary Driver #1 Drivers License#:

You must fill this field out to submit the form.

Motorcycle #2 Make (ex. Honda, BMW):

Vehicle #2 Year (ex. 1999, 2001):

^** Motorcycle #1 Engine Size CC (ex. 1854, 781):

You must enter a numeric value in this field.

^** Phone:

Fax:

Motorcycle #2 Engine Size CC (ex. 1854, 781):

^** Email Address

^** Motorcycle #1 Year (ex. 1999, 2001):

^** Motorcycle #1 Make (ex. Honda, BMW, Yamaha):

^** Motorcycle #1 Model (ex. interceptor, raider):

^** Motorcycle #1 VIN:

Primary Driver #2 Drivers License#:

Primary Driver #2 Date of Birth:

^** Primary Driver #1 Date of Birth (ex. 01/06/1960):

You must enter a Date value in this field.

^** Driver #1 Full Name:(Last Name, First Name MI):

^** Policy Holders Full Name(s) (Last Name, First Name MI):

^** Vehicle Garaging Address (include City ,State, Zip):

Mail Address if different from above (include City, State, Zip):

Driver #2 Full Name:(Last Name, First Name MI):

^** Please enter the name of previous Insurance Company. If there was no previous company enter (No Previous Company)

If Yes, please list drivers names with less than 5 years driving experience below.

If Yes, please list drivers names and explain the DUI below.

If Yes, please list drivers names and explain tickets or accidents below.

Motorcycle #1 Rental Car

Motorcycle #1 Towing

^** I agree and grant permission to obtain my personal information from consumer reporting agencies for the purpose of generating a Insurance quote.
You must acknowledge the following to receive a quotation for motorcycle coverage.

Garaging and Mailing Addresses are the Same

Motorcycle #2 Rental Car

Motorcycle #2 Towing

^** Insurance scores are subject to the Fair Credit Reporting Act. An insurance score is a type of consumer report similar to a credit report. Many insurance companies require favorable insurance score reports to qualify for their best rates.
I have been advised of my rights under the Fair Credit Reporting Act and authorize you to obtain my insurance score for the purpose of determining an insurance quotation for motorcycle coverage.

^** Have any drivers had an accident(s) or ticket(s) in the last three years?
Yes
No

^** Do any drivers listed above have less than 5 years experience driving?
Yes
No

^** Has any driver ever been convicted of DUI?
Yes
No

^** This information is collected for the purpose of obtaining a premium quote only. No coverage of any kind is bound by submitting information or receiving a quote.
I understand that I should maintain my current insurance coverage and receiving this quote does not provide any coverage.
Although I do not have any insurance I do realize receiving this quote it does not provide any coverage.