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Florida Motorcycle Insurance Quote
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Step 1 of 7 - Personal Information
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First Name:
*
Last Name:
*
Mailing Address:
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County:
*
State:
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Zip Code:
*
Have you resided at this address for more than 60 days?
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No
Please enter your previous address information below:
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Florida
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Fax #:
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Occupation:
Date of Birth:
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1920
Social Security #:
Is this policy a renewal policy?
select
yes
no
Previous Insurer:
Previous Expiration Date:
Month
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1921
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How many drivers to insure?
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1
2
Gender
Select
Male
Female
Date of Birth:
Month
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1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Marital Status:
Select
Married
Single
Driver's License #:
Years Licensed in Florida:
Select
0-3
> 3
Years Licensed in US:
Select
0-3
> 3
Do you hold a credit card?
Select
None
Mastercard
Visa
American Express
Discover
Other / Multiple
Any Liens or Bankruptcies:
Select
Yes
No
Please indicate any accidents or violations for this driver during the past 3 years.
Driver 1 - Accidents / Violations
None
Accident-at fault
Accident-not at fault
Accident w/DUI/DWI
Accident w/ reckless driving
Car pool lane violation
Careless/improper driving
Child restraint violation
Defective equipment
Defective/altered tag
Driving under influence
Driving while intoxicated
Driving without valid license
Driving without lights
Driving wrong way
Expired tag
Failure to signal
Failure to yield
False report
Fleeing to elude police
Hit and run
Lane change violation
Minor violation
Obstructing an officer
Obstructing traffic
Reckless/negligent driving
Racing
Refusal to submit
Running stop sign
Speeding 15 mph or under
Turning violation
Suspended and reinstated license
Defective brakes
Driving to fast for conditions
Driving w/ suspended license
Driving on the wrong side of the road
Failure to obey traffic device
Felony w/ a motor vehicle
Following too closely
Leaving the scene of an accident
Open container, driver
Open container, passenger
Passing stopped school bus
Speeding over 15 mph
Speeding highway under 16 mph
Date of Accident / Violation:
Month
1
2
3
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Day
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1932
1931
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1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Additional 1
I have additional accidents/violations
Driver 1 - Accidents / Violations 2
None
Accident-at fault
Accident-not at fault
Accident w/DUI/DWI
Accident w/ reckless driving
Car pool lane violation
Careless/improper driving
Child restraint violation
Defective equipment
Defective/altered tag
Driving under influence
Driving while intoxicated
Driving without valid license
Driving without lights
Driving wrong way
Expired tag
Failure to signal
Failure to yield
False report
Fleeing to elude police
Hit and run
Lane change violation
Minor violation
Obstructing an officer
Obstructing traffic
Reckless/negligent driving
Racing
Refusal to submit
Running stop sign
Speeding 15 mph or under
Turning violation
Suspended and reinstated license
Defective brakes
Driving to fast for conditions
Driving w/ suspended license
Driving on the wrong side of the road
Failure to obey traffic device
Felony w/ a motor vehicle
Following too closely
Leaving the scene of an accident
Open container, driver
Open container, passenger
Passing stopped school bus
Speeding over 15 mph
Speeding highway under 16 mph
Date of Accident / Violation:
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
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2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
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2002
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1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
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1972
1971
1970
1969
1968
1967
1966
1965
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1963
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1961
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1951
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1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Additional 2
I have additional accidents/violations
Driver 1 - Accidents / Violations 3
None
Accident-at fault
Accident-not at fault
Accident w/DUI/DWI
Accident w/ reckless driving
Car pool lane violation
Careless/improper driving
Child restraint violation
Defective equipment
Defective/altered tag
Driving under influence
Driving while intoxicated
Driving without valid license
Driving without lights
Driving wrong way
Expired tag
Failure to signal
Failure to yield
False report
Fleeing to elude police
Hit and run
Lane change violation
Minor violation
Obstructing an officer
Obstructing traffic
Reckless/negligent driving
Racing
Refusal to submit
Running stop sign
Speeding 15 mph or under
Turning violation
Suspended and reinstated license
Defective brakes
Driving to fast for conditions
Driving w/ suspended license
Driving on the wrong side of the road
Failure to obey traffic device
Felony w/ a motor vehicle
Following too closely
Leaving the scene of an accident
Open container, driver
Open container, passenger
Passing stopped school bus
Speeding over 15 mph
Speeding highway under 16 mph
Date of Accident / Violation:
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
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1991
1990
1989
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1987
1986
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1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
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1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Additional 3
I have additional accidents/violations
Driver 1 - Accidents / Violations 4
None
Accident-at fault
Accident-not at fault
Accident w/DUI/DWI
Accident w/ reckless driving
Car pool lane violation
Careless/improper driving
Child restraint violation
Defective equipment
Defective/altered tag
Driving under influence
Driving while intoxicated
Driving without valid license
Driving without lights
Driving wrong way
Expired tag
Failure to signal
Failure to yield
False report
Fleeing to elude police
Hit and run
Lane change violation
Minor violation
Obstructing an officer
Obstructing traffic
Reckless/negligent driving
Racing
Refusal to submit
Running stop sign
Speeding 15 mph or under
Turning violation
Suspended and reinstated license
Defective brakes
Driving to fast for conditions
Driving w/ suspended license
Driving on the wrong side of the road
Failure to obey traffic device
Felony w/ a motor vehicle
Following too closely
Leaving the scene of an accident
Open container, driver
Open container, passenger
Passing stopped school bus
Speeding over 15 mph
Speeding highway under 16 mph
Date of Accident / Violation:
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Additional 4
I have additional accidents/violations
Driver 1 - Accidents / Violations
None
Accident-at fault
Accident-not at fault
Accident w/DUI/DWI
Accident w/ reckless driving
Car pool lane violation
Careless/improper driving
Child restraint violation
Defective equipment
Defective/altered tag
Driving under influence
Driving while intoxicated
Driving without valid license
Driving without lights
Driving wrong way
Expired tag
Failure to signal
Failure to yield
False report
Fleeing to elude police
Hit and run
Lane change violation
Minor violation
Obstructing an officer
Obstructing traffic
Reckless/negligent driving
Racing
Refusal to submit
Running stop sign
Speeding 15 mph or under
Turning violation
Suspended and reinstated license
Defective brakes
Driving to fast for conditions
Driving w/ suspended license
Driving on the wrong side of the road
Failure to obey traffic device
Felony w/ a motor vehicle
Following too closely
Leaving the scene of an accident
Open container, driver
Open container, passenger
Passing stopped school bus
Speeding over 15 mph
Speeding highway under 16 mph
Date of Accident / Violation:
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Gender
Select
Male
Female
Date of Birth:
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
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24
25
26
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29
30
31
Year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
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1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Marital Status:
Select
Married
Single
Driver's License #:
Years Licensed in Florida:
Select
0-3
> 3
Years Licensed in US:
Select
0-3
> 3
Do you hold a credit card?
Select
None
Mastercard
Visa
American Express
Discover
Other / Multiple
Any Liens or Bankruptcies:
Select
Yes
No
Please indicate any accidents or violations for this driver during the past 3 years.
Driver 2 - Accidents / Violations
None
Accident-at fault
Accident-not at fault
Accident w/DUI/DWI
Accident w/ reckless driving
Car pool lane violation
Careless/improper driving
Child restraint violation
Defective equipment
Defective/altered tag
Driving under influence
Driving while intoxicated
Driving without valid license
Driving without lights
Driving wrong way
Expired tag
Failure to signal
Failure to yield
False report
Fleeing to elude police
Hit and run
Lane change violation
Minor violation
Obstructing an officer
Obstructing traffic
Reckless/negligent driving
Racing
Refusal to submit
Running stop sign
Speeding 15 mph or under
Turning violation
Suspended and reinstated license
Defective brakes
Driving to fast for conditions
Driving w/ suspended license
Driving on the wrong side of the road
Failure to obey traffic device
Felony w/ a motor vehicle
Following too closely
Leaving the scene of an accident
Open container, driver
Open container, passenger
Passing stopped school bus
Speeding over 15 mph
Speeding highway under 16 mph
Date of Accident / Violation:
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
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29
30
31
Year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
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1955
1954
1953
1952
1951
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1949
1948
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1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Additional Violation
I have an additional accidents/violations
Driver 2 - Accidents / Violations 2
None
Accident-at fault
Accident-not at fault
Accident w/DUI/DWI
Accident w/ reckless driving
Car pool lane violation
Careless/improper driving
Child restraint violation
Defective equipment
Defective/altered tag
Driving under influence
Driving while intoxicated
Driving without valid license
Driving without lights
Driving wrong way
Expired tag
Failure to signal
Failure to yield
False report
Fleeing to elude police
Hit and run
Lane change violation
Minor violation
Obstructing an officer
Obstructing traffic
Reckless/negligent driving
Racing
Refusal to submit
Running stop sign
Speeding 15 mph or under
Turning violation
Suspended and reinstated license
Defective brakes
Driving to fast for conditions
Driving w/ suspended license
Driving on the wrong side of the road
Failure to obey traffic device
Felony w/ a motor vehicle
Following too closely
Leaving the scene of an accident
Open container, driver
Open container, passenger
Passing stopped school bus
Speeding over 15 mph
Speeding highway under 16 mph
Date of Accident / Violation:
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
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10
11
12
13
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24
25
26
27
28
29
30
31
Year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Additional Violation 2
I have an additional accidents/violations
Driver 2 - Accidents / Violations 2
None
Accident-at fault
Accident-not at fault
Accident w/DUI/DWI
Accident w/ reckless driving
Car pool lane violation
Careless/improper driving
Child restraint violation
Defective equipment
Defective/altered tag
Driving under influence
Driving while intoxicated
Driving without valid license
Driving without lights
Driving wrong way
Expired tag
Failure to signal
Failure to yield
False report
Fleeing to elude police
Hit and run
Lane change violation
Minor violation
Obstructing an officer
Obstructing traffic
Reckless/negligent driving
Racing
Refusal to submit
Running stop sign
Speeding 15 mph or under
Turning violation
Suspended and reinstated license
Defective brakes
Driving to fast for conditions
Driving w/ suspended license
Driving on the wrong side of the road
Failure to obey traffic device
Felony w/ a motor vehicle
Following too closely
Leaving the scene of an accident
Open container, driver
Open container, passenger
Passing stopped school bus
Speeding over 15 mph
Speeding highway under 16 mph
Date of Accident / Violation:
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Liability Limits for Bodily Injury:
Select
Declined
$10,000 / $20,000
$25,000 / $50,000
$50,000 / $100,000
$100,000 / $300,000
Liability Limits for Property Damage:
Select
$10,000
$25,000
$50,000
$100,000
Uninsured Motorist:
Select
No Coverage
$10,000 / $20,000
$25,000 / $50,000
$50,000 / $100,000
$100,000 / $300,000
$250,000 / $500,000
Guest Passenger Liability:
Select
No Coverage
$10,000 / $20,000
$25,000 / $50,000
$50,000 / $100,000
$100,000 / $300,000
Medical Payment Coverage:
Select
None
$1,000
$2,500
$5,000
$10,000 (Helmet Law)
($10,000 required for new Helmet Law)
Bike Make
Bike Model
Year
Select
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
Engine Displacyment in CCs:
Collision Deductible:
Select
No Coverage
$250
$500
$1,000
$2,500
Comprehensive Deductible:
Select
No Coverage
$250
$500
$1,000
$2,500
Motorcycle Use:
Select
Personal
To / From Work
Business
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