Add / Remove Driver Form

Add / Remove Driver form
Name of person requesting this change

First NameLast Name
Your Phone Number
Please enter a valid phone number.
Your Best Email Address
example@example.com
Your Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Add Driver information
Does this person live in your household?
Address where this driver resides

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this driver a full time student?
If they have above a 3.0 GPA, please upload proof of most recent FULL semester grades showing their grades/GPA and some identifying information. OR use the option below to take a photo of that documentation

Cancelof
Take Photo
REMOVE Driver information
Remember, no coverages can be bound, changed, or cancelled until you get confirmation from a licensed agent of the McGinniss Himmel Insurance Agency, LLC. This form allows us to more accuratly and quickly help get you taken care of, but submission of this form does not bind, alter, or change your coverage. We OFTEN can respond to these within 4-6 business hours, but please allow us 24 hours (Monday-Friday) to review and contact you with options and confirmation of coverage.
Please verify that you are human*
Should be Empty:

Add / Remove Driver form