Leland Smith Insurance Services for Residential and Business. Insuring your home, auto, health and business.  
   
Untitled Document

Policy Changes > Auto > Add/Remove Driver

 Existing Clients
Add or Remove a Driver
Please carefully fill out and submit the form on the left. Your information will be submitted to our office and processed as quickly as possible.
Add Driver Remove Driver
Effective Date:
Policy Number:
Primary Policyholder's Name:
Insurance Company
Driver's Name:
 
Fields below need to be completed only if adding a driver:
 
Principal Driver Occasional Driver
Vehicle Driven Most:
Good Student?
Student Away from Home w/ Car?
Date Licensed (If New Driver):
   

If there is also a new vehicle that needs to be insured, You will also need to complete the Add Vehicle Form after this form is submitted

 
(Please verify all fields have been properly completed)

We appreciate your business and hope that you find our online resources useful. If you have questions, please feel free to Contact Us.
Independent Insurance Agent Leland Smith Insurance Services
1175 Westwood Dr. Suite 200
Van Wert, OH 45891-2464		 Trusted Choice -- We serve you first.

Home | Locations | Contact Us | Apply for Coverage | Privacy Notice

Leland Smith Insurance Services, Inc., is licensed to conduct business in the States of Indiana and Ohio. The information on this site is a solicitation to conduct business in the aforementioned states of authority.