Auto Insurance (NJ) - Chester, Morris County, Middlesex County, Piscataway, New Brunswick, Princeton, Clinton, Mount Olive & Long Valley

Phone: 908-879-4227
Email: info@crossenagency.com
Hours: M-F 9am - 6pm Sat: 9am - 12 pm

Auto


Name
Address: (No P.O. Box)
City
Zip Code
Phone
Fax
Date of Birth:
Years licensed:
State:
Driver's License Number:
Marital Status:	Single Married Divorced
Have you moved in the last 60 days?	Yes No
Do you own your home, rent or live with parents?
Do you currently have an auto insurance policy?	Yes No
If yes, Policy number and company:
By what date is coverage needed?
Has there been a coverage lapse greater than 30 days in the past 6 months?	Yes No
Vehicle #1 Year, Make and Model:	a) b) c)
Vehicle # 1 Vin/Serial Number:	a) b)
Vehicle #2 Year, Make and Model:	a) b) c)
Vehicle #2 Vin/Serial Number:	a) b)
Liability Limits:
Comprehensive & Collision Deductible:
If there are other drivers in the household, please provide: Name, Date of Birth and Drivers License # :


Social Security numbers are also needed for accurate insurance quoting, however for protection against identity theft, please do not transmit that vital personal information via e-mail. Our office will call you directly to obtain this private information.

Why Us

We distinguish ourselves from other agents:

Will visit your home, school or business
(or you can visit our office)
Open on Saturdays
Provide phone coverage from 8:00 am to 6:00 pm (Mon.– Fri.)
Focus is on graduate school students with weekly campus visits to New Brunswick, Piscataway & Princeton
Cancellation notice follow-up phone calls (provides back-up awareness of pending coverage lapse)
Provide same day quotes and coverage via phone, e-mail or fax