Agreement to Provide Insurance: (#4810)

Bulk Pricing:

Below are the available bulk discount rates for each individual item when you purchase a certain amount

  • Buy 10 or above and pay only $18.99 each
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Make sure your F&I office is ready to go with our Agreement to Provide Insurance forms.

Stay compliant and avoid last minute hassles with you indirect lending partners when providing insurance information from your customers. Protect yourself and your business by insuring that a customer’s coverage transfers with them the minute they leave your dealership lot. Make sure post delivery their damage is not your loss! The Agreement to Provide Insurance form is a convenient way for the dealer to obtain insurance information from the customer and confirm coverage with the insurance agent or company. 

NOTE: We have changed the print color shading and some of the wording on this form. The print layout has not changed and will continue to line up when printed on.

8-1/2" x 7
4-part snap-out
Carbonless - White, Canary, Pink, Goldenrod
Prints in Black and Red Ink
Qty: 100 Per Pack
Quantity price breaks are: 1, 3, 5, 10 packs