PL Renewal - Garcia Insurance Services

New Kenner Location: 2400 Veterans Ste 115

Address: 3815 MacArthur Blvd New Orleans, LA 70114
Phone: (504) 875-4077
Email: info@gisnola.com

About
Personal
Business
Service Center
- Billing & Claims
Contact

If you have replaced your roof within the last 5 years please send PAID receipt for installation or a statement from a licensed roofer showing installation date/estimated age of roof to documents@gisnola.com

Personal Lines Renewal Client Update Form

Step 1 of 12

Name

First Last

Are you driving for a rideshare or delivery company?

Yes

If yes what company?

Have you started using your vehicle for business?

Yes

(Roofing, real estate, advertisement, etc.)

What Business?

Please check all situations that apply to you.

Address Change

Birth of a child

Career Change

Driver Added

Driver Removed

Home renovations/improvments

Marital Status

Purchased ATV/Motorcycle/Slingshot

Purchased Boat

Purchased Home/Rental Property/Second Home

Started A Business

Vehicle Bought

Vehicle Sold

No Changes

Date You Moved

MM slash DD slash YYYY

Updated Address

Street Address Address Line 2 City State ZIP Code

Name

Birthday

Congrats on the new career! What is your new job title?

Add Driver To Policy

First Last

Birthday

Relationship to You

DL #

Remove Driver From Policy

First Last

What is your current marital status?

Married

Divorced

Widowed

Spouse Name

What new toy(s) did you purchase?

ATV

Boat

Golf Cart

Motorcycle

Slingshot

List make, model and estimated purchase price for each new toy.

Year

Make

Model

Click the + to add more rows.

What type of property did you purchase?

Primary Home

Rental Home/Investment Property

Second Home/Vacation Home

Date Purchased

MM slash DD slash YYYY

New Property Address

Street Address Address Line 2 City State ZIP Code

Is the Property currently insured? With who?

What is the name of your new business?

What is the industry of your new business?

Have you started a home-based business?

Yes

Is your business currently insured?

Yes

Date Purchased

MM slash DD slash YYYY

Year/Make/Model of purchased vehicle(s)

Year

Make

Model

Click the + to add rows for additional vehicles.

Date Sold

MM slash DD slash YYYY

Year/Make/Model of sold vehicle(s)

Year

Make

Model

Click the + to add rows for additional vehicles.

Please list the renovations and an approximate cost of each.

You can use the + button on the right side to add additional rows.

Request for referral like on Commercial?

Yes

Are there any additional changes that we should know about prior to your insurance renewal?

This field is for validation purposes and should be left unchanged.

Main Office 3815 MacArthur Blvd New Orleans, LA 70114
Phone: (504) 875-4077
Email: info@gisnola.com

Kenner Location 2400 Veterans Blvd, Ste 115, Kenner LA 70062
Phone: (504) 875-4077
Email: info@gisnola.com

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Billing & Claims
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