MK Insurance - Auto Easy Quote

Drivers

You can include up to four drivers per quote. If you would like to add more than four, please contact us.

Number of Licensed Drivers in Household

1 2 3 4

Driver 1 Details

First Name

Middle Initial

Last Name

Gender

Marital Status

Birth Month

Birth Day

Birth Year

Driver 2 Details

First Name

Middle Initial

Last Name

Gender

Marital Status

Relation to Driver 1

Birth Month

Birth Day

Birth Year

Driver 3 Details

First Name

Middle Initial

Last Name

Gender

Marital Status

Relation to Driver 1

Birth Month

Birth Day

Birth Year

Driver 4 Details

First Name

Middle Initial

Last Name

Gender

Marital Status

Relation to Driver 1

Birth Month

Birth Day

Birth Year

Vehicles

You can include up to four vehicles per quote. If you would like to add more than four vehicles, please contact us.

Number of Vehicles You Want to Insure

1 2 3 4

Vehicle 1 Details

Model Year

Vehicle Make

Vehicle Model

Choose the level of liability coverage you would like. Applies to all applicants on the policy

Standard

Bodily Injury Liability:
$100,000 Per Person
$300,000 Per Accident

Under/Uninsured Motorist:
$100,000 Per Person
$300,000 Per Accident

Property Damage Liability:
$100,000 Per Accident

Superior

Bodily Injury Liability:
$250,000 Per Person
$500,000 Per Accident

Under/Uninsured Motorist:
$250,000 Per Person
$500,000 Per Accident

Property Damage Liability:
$100,000 Per Accident

Basic

Bodily Injury Liability:
$50,000 Per Person
$100,000 Per Accident

Under/Uninsured Motorist:
$50,000 Per Person
$100,000 Per Accident

Property Damage Liabillity:
$100,000 Per Accident

Residence

Current Residence Information

Address

Apt/unit

City

State

Zip Code

Phone

Email Address

Own or Rent

Years at Address

Discounts

Additional Discount Opportunities

Select The Additional Discounts That May Be Right For You:

Pay In Full Discount (Pay the total 6 month premium in full)

Multiple Policy Discount (Insure your home, condo or renters with us)

First Responder Discount (Current or retired Police, Fire, Sheriff or Paramedic)

How did you hear about us?

Name of the person who referred you to us (If any).

Drivers

Driver 1 Details

Driver 2 Details

Driver 3 Details

Driver 4 Details

Vehicles

Vehicle 1 Details

Vehicle 2 Details

Vehicle 3 Details

Vehicle 4 Details

Choose the level of liability coverage you would like. Applies to all applicants on the policy

Residence

Current Residence Information

Prior Residence Information

Discounts

Additional Discount Opportunities