3 REGISTRANT If you have taken a photo of your Vehicle’s Registration and imported it in Step 1, it should appear below. If your Vehicle Registration doesn’t appear below, please take a photo of your Vehicle Registration and drag and drop into the box below REGISTRANT — Enter registrant information EXACTLY as printed on registration REGISTRANT OF VEHICLE 1 Name — exactly as printed on registration Date of Birth Sex Address (include Number & Street) Apt. Number City or Town Sate Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code Plate Number State of Reg. Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Vehicle Year & Make Vehicle Type Insurance Code REGISTRANT OF VEHICLE 2 If you have taken a photo of the Vehicle’s Registration of the Registrant of Vehicle 2 and imported it in Step 1, it should appear below. If the Vehicle’s Registration of the Registrant of Vehicle 2 doesn’t appear below, please take a photo of the Vehicle’s Registration of the Registrant of Vehicle 2 and drag and drop into the box below Name — exactly as printed on registration Date of Birth Sex Address (include Number & Street) Apt. Number City or Town Sate Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code Plate Number State of Reg. Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Vehicle Year & Make Vehicle Type Insurance Code Back Next
