Auto Insurance Quote Request

Please take a moment to fill out the form below and one of our representatives will contact you with a free, no-obligation quote.

PRIVACY PRE-NOTIFICATION: The Howard French Insurance Agency has a privacy policy to protect and keep this information  confidential and will be used for quote purposes only.

* Required fields.

Personal Information
Full Name: *
Address: *
City: *
State: *    Zip: *
Daytime Phone: *   Night Phone: *
Best Time To Call:  AM   PM
E-mail Address: *

Current Auto Insurance Information
Company Name:
(not agency)
Policy Expiration Date:   Premium Amount: $
Policy Term: 6 Months   1 Year  
Years Insured:

Vehicle Information (All cars you or your family members own or lease) *
Car
#1 		Year Make Model Body Type
Car
#2 		Year Make Model Body Type
Car
#3 		Year Make Model Body Type
Car
#4 		Year Make Model Body Type

Liability Limit For ALL Cars
Choose either:
Bodily Injury   and   Property Damage

Bodily Injury
Property Damage 		OR            Single Limit

Single Limit

Deductibles
  Comprehensive Deductible Collision
Deductible 		Towing Rental
Reimbursement
Car #1 Yes Yes
Car #2 Yes Yes
Car #3 Yes Yes
Car #4 Yes Yes

Excess Liability
Personal
Umbrella Coverage:		 Yes  No Amount:

Additional Comments or Questions

Please click the "Submit Quote" button to send your quote request. No coverage is in effect until bound by an insurance carrier. This is a request for quotation only.

**Privacy Policy Notification**

In order to determine your eligibility, we are required to verify your loss history and credit history using consumer reports. You understand and agree that any personal information about you that you provide or that we obtain from any consumer report may be used by any company within the Nationwide Insurance group of insurance companies to issue, review and renew the insurance for which you are applying. You have the right to access and correct all personal information collected.

If you do not want us to order a credit and claims report, we can still provide you with a conditional quote; however without these reports, the quote may be rather inaccurate and cannot be used as final rates for your mortgage company or budgetary purposes.


The Howard French Insurance Agency
2616 South Loop W., Suite 597
Houston, Texas 77054
281-677-9491 office | 281-677-9492 fax

"The greatest compliment we can receive is your referral."