Welcome to Jennings Insurance

Online Auto Insurance Quote

You may submit information here to receive a free email quote on auto insurance.

How would you like your quote?

You can also receive a free quote from us by calling our office at 320-252-3460.

General Information

	First	Last
Your Name:
Email Address:
Your Address:
City:		State:	Zip:

Phone:

Driver Information

Number of drivers on your policy:

Please list full name, date of birth,
and driver license number for all drivers in your household.

Name

Date of Birth

Driver License Number

Vehicle Information

Number of vehicles on your policy:

Vehicle #1

Vehicle #2

Vehicle #3

Year

Make

Model

Body Type

VIN#
(17 characters)

4-wheel drive
Yes No Yes No Yes No

Anti-lock brakes
Yes No Yes No Yes No

Auto seatbelt
Yes No Yes No Yes No

Airbags
Yes No Yes No Yes No

Good student
Yes No Yes No Yes No

Primary driver

Miles to work

Use of vehicle

Coverages

Coverages Make Choice For Which Vehicles?

Liability All
#1
#2
#3

Comprehensive Deductible All
#1
#2
#3

Collision Deductible All
#1
#2
#3

Full Glass Yes No All
#1
#2
#3

Towing Yes No All
#1
#2
#3

Rental Reimbursement Yes No All
#1
#2
#3

Additional Information

List ALL
Accidents and Violations
in the last 5 years
for ALL
licensed members
of the household:

Present Carrier

Expiration Date

Do you own your home?
Yes No

If yes, home insurance policy expiration date

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Driver Information

Name Date of Birth Driver License Number

Vehicle Information

Vehicle #1 Vehicle #2 Vehicle #3 Year Make Model Body Type VIN# (17 characters) 4-wheel drive Yes No Yes No Yes No Anti-lock brakes Yes No Yes No Yes No Auto seatbelt Yes No Yes No Yes No Airbags Yes No Yes No Yes No Good student Yes No Yes No Yes No Primary driver Miles to work Use of vehicle

Coverages

Additional Information

Name

Date of Birth

Driver License Number