| Auto Lead | Lead ID: 6033 |
| Contact Information: | |||||
|---|---|---|---|---|---|
| Name: | Grant Smith | Email: | email@sbcglobal.net | ||
| Address: | 123 Main Ave | Day Phone: | 555-555-5555 | ||
| City, State, Zip: | Petoskey, MI | Home Phone: | |||
| Zip: | 49770 | Cell Phone: | |||
| Resident Status: | Own | Resident For: | 8yr. 8mo. | ||
| Desired Coverage: | |||||
| Bodily Injury/Uninsured: | $100,000 / $300,000 | Property Damage: | $50,000 | ||
| Prior Insurance Information: | |||||
| Company: | Liberty Mutual | Insured For: | 6yr. 0mo. | ||
| Policy Renew Date: | 08-29-2011 | ||||
| Driver #1: | |||||
| Driver Name: | Grant Smith | Relationship: | Applicant | ||
| License Status: | Active | Gender: | Male | ||
| Date of Birth: | 07-30-1952 | Marital Status: | Single | ||
| Age Licensed: | 16 | State Licensed: | MI | ||
| Occupation: | Retail | Education: | Bachelors Degree | ||
| SSN: | License Number: | D0000000 | |||
| SR-22 Filing: | No | Violations: | No | ||
| Vehicle #1: | |||||
| Year, Make: | 1992 BUICK | Primary Driver: | Grant Smith - Driver 1 | ||
| Model: | ROADMASTER ESTATE STATION WAGON | Ownership: | Owned | ||
| Vehicle Use: | Work Commute | Annual Milage: | 5,000 | ||
| Comprehensive: | $500 | Collision: | $500 | ||
|
Find Out More: Call us at 855-467-9268 or Visit us at www.InsuranceIwant.com for more information. | |||||