As a valued customer of The SCHONNING Insurance Agency, you can quickly obtain proof of insurance for your property or vehicle by completing the form below. Your request will be handled immediately.

Proof of Insurance

Name of Insured:

First Name:  Middle Initial:
Last Name:

Contact Information for party requiring proof of insurance:

Name of Financial Institution, Dealership,
or Certificate Holder:

Name of Contact Person:

Address:
                

City:  State:

Telephone:  Fax Number:

Proof of Insurance Required:

Binder ID Card    Certificate of Insurance
   Other:

Please List As:

Additional Insured
Loss Payee
Mortgagee                       Address:
Certificate Holder                          

City:  State:

Property Information:

If this request is being submitted regarding real estate or business insurance, once you've completed this section you may submit the form. (Press "ENTER" or "SUBMIT")
If you're requesting insurance information pertaining to an automobile, skip to the new vehicle information section below, complete the remainder of the form, and then press "SUBMIT".
Subject Property Address: 
                                                

City:  State:

New Vehicle Information:

What year was the vehicle manufactured?

What make is the vehicle?
What model is the vehicle?
What color is the vehicle?
How many cylinders does the motor of the vehicle have?
VIN#:

# of airbags:   mileage:       ABS    4X4

Alarm Type: Passive   Active   None

Deductibles:   Comprehensive $  
                                       Collision$

Date insured is taking possession of the vehicle:

Trade In Vehicle Information:

Are you taking a vehicle in trade? Yes   No

If applicable;
What year was the trade-in vehicle manufactured?

What brand is the trade-in vehicle?
What model is the trade-in vehicle?

Completion of this form does not bind coverage. This form is only provided to expedite exchange of information for our clients. We will need to confirm any changes with our insured by telephone before coverage is bound. If this submittal is regarding a new vehicle, you must fax us a copy of the window sticker @ (401) 348 - 2008.