Adding New DriverVanessa Lares2025-09-15T12:15:08-07:00

Adding New Driver

Step 1 of 2

Effective date to add driver:

Account Owner(Required)

Client Number(Required)

Client Name(Required)

First Last

DRIVER'S INFO

Name(Required)

First Last

REPLATIONSHIP TO INSURED(Required)

Date of Birth

Sex

Marital Status

LICENSE INFO:

STATE LICENSED

LICENSE #

DATE FIRST LICENSED

Additional Licensing Information

EMPLOYMENT OR SCHOOL INFO

JOB TITLE

NAME OF EMPLOYER OR SCHOOL

EMPLOYER/ SCHOOL ADDRESS

Address Line 1 Address Line 2 City State Zip Code

YEARS EMPLOYED

WHICH VEHICLE THIS DRIVER PRIMARILY DRIVE?(Required)

USAGE ON THE VEHICLE(Required)

DISTANCE TO AND FROM WORK/SCHOOL

ESTIMATED ANNUAL MILEAGE FOR THE VEHICLE THEY WILL DRIVE

Start Insurance Quote

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1163 N Tustin St.

Orange, California 92867

Phone: 714-288-8000
Email: insure@laresinsurance.com

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702 W Lincoln Ave.

Anaheim, California 92805

Phone: 714-254-1900
Email: insure@laresinsurance.com

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