Stoltzfus RV’s and Marine Secure Online Quote This Quote is secure and your information is encrypted during transfer. Required fields are marked with an asterisk * and are needed for correct processing of your quote. Type of Insurance*Type of InsuranceAutoHomeownersMotorcycle / ATVGolf CartBoats / WatercraftMexico LiabilityUmbrella LiabilityClassic CarsDealer's InformationDealer Name* Salesperson Name* How would you like us to get in touch with the RV Quote? Phone Email Customer Waiting How would you like us to get in touch with the RV Quote? Phone Email How would you like us to get in touch with the Quote? Phone Email Do you have the Bill of Sale?* Yes No Please Upload the Bill of Sale* Drop files here or Select files Max. file size: 64 MB. Marital Status*Marital StatusMarriedSingleDivorcedWidowedDate of Birth* Email Address* Phone Number* Owner's InformationFirst Name* Last Name* Phone Number* Email Address* Mailing Address* City* State*StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code* Date of Birth* Marital Status*Marital StatusMarriedSingleDivorcedWidowedSpouse Full Name* Spouse Date of Birth* Vehicle InformationYear* RV Type*RV TypeMotor HomeFifth WheelTravel TrailerVan CamperPopup CamperTruck CamperPark ModelStationary TrailerMake/Manufacturer* Model* Model/Floorplan/Series* Length of RV* Width of RV* Purchase Price*If new, include tax, title & all feesPurchase Price*Purchase Information* New Used Date of Purchase* Travel Trailer Vehicle Usage* Tow Stationary Campground Name & Site Number Are there any attachments to the unit? i.e. sunroom, porch, deck* Yes No Type of attachment(s) and dimensions:*Do you have any unattached structures? i.e. shed, gazebo, detached deck* Yes No Type of unattached structure(s) and approximate value:*Park Model Address InformationLocation Address* City* State*StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code* Is this location in a campground?* Yes No Stationary Trailer Address InformationLocation Address* City* State*StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code* Is this location in a campground?* Yes No Other Address InformationIs this unit stationary in a campground?* Yes No Is your registration address the same as your mailing address?* Yes, same address No, different address Registration Address* City* State*StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code* Is the location of your unit the same as your residence?* Yes, same address No, different address Unit Location Address* City* State*StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code* Underwriting QuestionsDo you currently have insurance on this property?* Yes No Is this your primary residence?* Yes No Will the unit be rented out for a fee?* Yes No Underwriting QuestionsDuring the past 3 years have you had any accidents or violations? Yes No Please explain the incident(s).Will this be your full time residence 5 or more months per year? Yes No Will this be used for any business purposes or rented to others for a fee? Yes No Do you intend to ever tow this trailer? Yes No Will this trailer be blocked and/or skirted? Yes No Just a Few More QuestionsThis part can save you moneyIs it equipped with airbags? Yes No Is it equipped with anti-lock brakes? Yes No Is it equipped with an audible anti-theft device? Yes No Are you a member of an RV association or manufacturers club? Yes No Do you have a commercial driver's license (CDL)? Yes No Have you taken a defensive driving course? Yes No Do you own a home? Yes No Lien Holders InformationLien Holder Name Mailing Address City StateStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code Additional InformationDo you currently have flood insurance? Yes No Are you interested in receiving a quote for flood insurance? Yes No How did you hear about us?How did you hear about us?RV DealerTrade PublicationSearch EngineSocial MediaFriendPhone BookOtherGAP Provided?* Yes No Comments / QuestionsDisclaimer*Many states now permit the use of insurance scoring in determining RV insurance premiums. Your insurance score is a number based on the information contained in your credit report. Many of the companies, which we represent, use consumer reports, Application information, driving history and claims history to determine the most favorable rate. By submitting this quote request you are authorizing our agency and/or our companies access to these reports for this purpose. I have read the disclaimer Disclaimer*Many states now permit the use of insurance scoring in determining insurance premiums. Your insurance score is a number based on the information contained in your credit report. Many of the companies, which we represent, use consumer reports, Application information, driving history and claims history to determine the most favorable rate. By submitting this quote request you are authorizing our agency and/or our companies access to these reports for this purpose. I have read the disclaimer Disclaimer*Many states now permit the use of insurance scoring in determining RV insurance premiums. Your insurance score is a number based on the information contained in your credit report. Many of the companies, which we represent, use consumer reports, Application information, driving history and claims history to determine the most favorable rate. By submitting this quote request you are authorizing our agency and/or our companies access to these reports for this purpose. Submission of this quote request assures us that you have advised your customer that an insurance score, obtained from a credit report, may be used to determine the best rate available. I have read the disclaimer PhoneThis field is for validation purposes and should be left unchanged.
