Replace a Vehicle Are you replacing your old daily driver with your dream car? Possibly trading in your Pickup for an EV? Making the switch is as simple as filling out the details below! Company First & Last Name of Policy Holder * Policy Number * Effective Date * Email Address * Phone Number * New Vehicle Information Vehicle Year * New Vehicle Make * VIN # (17 digits) * Registered Owner's Name * Name of Primary Driver * Vehicle Being Replaced Vehicle Year * New Vehicle Make * VIN # (17 digits) * Is There a Loan on This Vehicle * Yes No Preferred Method of Contact * Email Phone Coverage Type * Full Coverage On This Vehicle Liability Only On This Vehicle Comments Agreement: I understand that no coverage is effective until I receive confirmation from a representative of Willow Insurance Agencies, LLC or from my insurance carrier. Privacy Policy * Coverage on your policy cannot be bound only by filling this form. Only after you confirm the information with one of your team members will the changes go into effect.
