Request an Auto Quote

Automobile Quote

Please complete the information below and remember we are always here to answer your questions.

Contact Information
Name*
Address
 
City
State
Zip
Daytime Phone Number
Nighttime Phone Number
Best Time to Call
Email Address*
* required fields
Current Auto/Motorcycle Insurance Information
Company Name
(not agency)
Policy Expiration Date
Premium Amount
Term
Auto/Motorcycle Information
(include all autos/motorcycles you or your family members own or lease)
Car/Motorcycle One
Year
Make
Model
Body Type
VIN#
Title Holder
Annual Mileage
Usage
Engine Size
Air Bags Yes
No
Car Alarm Yes
No
If vehicle is kept at an address other than that listed above, please indicate below.
Location City
Location State
Location Zip
Car/Motorcycle Two
Year
Make
Model
Body Type
VIN#
Title Holder
Annual Mileage
Usage
Engine Size
Air Bags Yes
No
Car Alarm Yes
No
If vehicle is kept at an address other than that listed above, please indicate below.
Location City
Location State
Location Zip
Car/Motorcycle Three
Year
Make
Model
Body Type
VIN#
Title Holder
Annual Mileage
Usage
Engine Size
Air Bags Yes
No
Car Alarm Yes
No
If vehicle is kept at an address other than that listed above, please indicate below.
Location City
Location State
Location Zip
Car/Motorcycle Four
Year
Make
Model
Body Type
VIN#
Title Holder
Annual Mileage
Usage
Engine Size
Air Bags Yes
No
Car Alarm Yes
No
If vehicle is kept at an address other than that listed above, please indicate below.
Location City
Location State
Location Zip
Liability Limit For ALL Vehicles
(Choose either Bodily Injury and Property Damage or Single Limit)
Bodily Injury
Property Damage
Single Limit
Uninsured/Underinsured
Deductible Information
Vehicle# Comprehensive Deductible Collision Deductible Towing Rental Reimbursement
1 Yes No Yes No
2 Yes No Yes No
3 Yes No Yes No
4 Yes No Yes No
Driver Information
(include all licensed drivers in your household)
Driver One
Driver Name
License Class
(Standard, CDL, Motorcycle, Bus, etc.)
Drivers License #
State/Province
Number of Years Licensed
Relation
Date of Birth
Sex Male Female
Marital Status
Courses Completed in the last 3 years (drivers ed): Yes No
Driver Two
Driver Name
License Class
(Standard, CDL, Motorcycle, Bus, etc.)
Drivers License #
State/Province
Number of Years Licensed
Relation
Date of Birth
Sex Male Female
Marital Status
Courses Completed in the last 3 years (drivers ed): Yes No
Driver Three
Driver Name
License Class
(Standard, CDL, Motorcycle, Bus, etc.)
Drivers License #
State/Province
Number of Years Licensed
Relation
Date of Birth
Sex Male Female
Marital Status
Courses Completed in the last 3 years (drivers ed): Yes No
Driver Four
Driver Name
License Class
(Standard, CDL, Motorcycle, Bus, etc.)
Drivers License #
State/Province
Number of Years Licensed
Relation
Date of Birth
Sex Male Female
Marital Status
Courses Completed in the last 3 years (drivers ed): Yes No
Driver History
(Please list ANY convictions for ANY driver convicted of moving traffic violations in the past 3 years)
Driver One
Date
Type of Conviction
Fines
Over Limit
Driver Two
Date
Type of Conviction
Fines
Over Limit
Driver Three
Date
Type of Conviction
Fines
Over Limit
Driver Four
Date
Type of Conviction
Fines
Over Limit
Please list ANY driver who has had license suspensions, revocations or DUI convictions below.
Driver License Suspended or Revoked DUI Conviction For
1
2
3
4
Please list ANY driver involved in accidents, regardless of fault, in the past 5 years
Driver One
Date
Description
Cost
At Fault Yes
No
Injuries Yes
No
Driver Two
Date
Description
Cost
At Fault Yes
No
Injuries Yes
No
Driver Three
Date
Description
Cost
At Fault Yes
No
Injuries Yes
No
Driver Four
Date
Description
Cost
At Fault Yes
No
Injuries Yes
No
Additional Information
Please give any additional comments you feel appropriate for this quotation. If you have additional information where there was not enough fields above, such as additional drivers, vehicles, driver histories, etc..., please enter them here.
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What Our Customers Say!

Wilson Insurance Services consistently responds to all of my insurance needs.  They are real, caring people.  Linda, Dee, Jennifer, Bobbi and Fletcher are experienced professionals.  They are not just a voice on the other end of the phone somewhere.  They are truly a fantastic, service-centered Insurance Agency.

Angela Johnson Howell

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What's New

What You Should Know About Rental Car Insurance
8/1/2017
There are some very serious contractual gaps in coverage for rental vehicles. Even if you purchase their Collision Damage or Physical/ Loss Damage Waivers, many rental car contracts exclude the following:
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  • Tolling, or Turning the Vehicle Over
  • Lease Gap coverage
  • Loss of Use
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  • Drivers who rent, and do not own another vehicle insured elsewhere, need to be expecially careful here
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5 Ways to Control Rising Homeowners Insurance Premiums
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Just as with real estate values, location rules when it comes to homeowners insurance costs. According to the National Association of Insurance Commissioners, the average annual U.S. premium was $842 in 2015, the most recent year for which figures are available. Floridians paid the highest rates, averaging $1,534 a year, while at the opposite end of the spectrum, homeowners in Idaho paid $422.  North Carolina residents averaged $664 per year. 
 
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5 Reasons Why Auto Accidents Are on the Rise
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According to the National Safety Council, traffic deaths increased 6 percent to 40,200 — the first time since 2007 that more than 40,000 have died in motor vehicle crashes in a single year.The 2016 total follows a 7 percent rise in 2015. Much of this is attributed to continued lower gasoline prices and an improving economy which has increased motor-vehicle mileage. 

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