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For Michigan Residents Only!



Do you Currently Have Auto Insurance?
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Number of Vehicles to Insure
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Vehicle #1
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Vehicle 1 VIN
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Vehicle #2
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Vehicle 2 VIN
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Vehicle #3
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Vehicle 3 VIN
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Vehicles With Full Coverage
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Additional Vehicles - List Here
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Comprehensive Deductible
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Collision Deductible
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Collision Type
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Towing
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Rental
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Current Liability Coverage (Bodily Injury)
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Medical Insurance
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Total People in Household (incl. Kids)
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Total Licensed Drivers in Household
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Marital Status
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Residence Info
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First Name
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Last Name
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Date of Birth
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Driver 2 (Full Name)
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Date of Birth
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Driver 3 (Full Name)
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Date of Birth
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List any Additional Drivers and Date of Birth's
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Any Tickets/Accidents in the last 3 yrs for any Driver? (list driver, date, and violation)
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Member of any of these Groups?
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Member of a Credit Union?
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If Yes, Which Credit Union? (List Multiple)
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Do you currently or are you interested in also bundling your Home/Renter policies?
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Do you currently or would you like to bundle an umbrella policy?
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Would you like to bundle a no exam life insurance policy? (In some cases the policies will be free due to multi policy discount)
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Street Address
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City
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ZIP / Postal Code
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How Many Years at Current Address?
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If less than 2 years at current address, list previous address:
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Primary Phone Number
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E-Mail Address
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What lead you to our site?
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Any Additional Info?
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Important Notice:

Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages.  Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company.  If you have any questions, please feel free to contact us. Per the terms of our online privacy policy we will not resell your information to any third-party.

  
    Disclaimer: Schwab Insurance Agency is not affiliated with Charles Schwab & Co., Inc. or Charles Schwab Bank N.A.

    We Proudly serve all of Michigan, including Millington, Otisville, Columbiaville, Fostoria, & Otter Lake in Tuscola,
    Genesee, Saginaw, and Lapeer County.