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    Personal Auto Insurance
    Change or Inquiry

    Change
    Policy Number:  
    Your Name:  
    E-mail Address:  
    Daytime Phone#:  
    Choose One: Please call to discuss my policy   -or-
    See change information below:
    Delete Vehicle: Year       VIN Make/Model
      Sold  Stored  Traded 
    Other:
    Add Vehicle: Year       VIN Make/Model
       Owner
       Primary Driver
       Describe Use
    Coverage Requested: Same coverage as deleted vehicle. -or-
    See additional coverage selections below.
    Additional Coverage:

    (Please use Other Comments area below for any desired coverage not listed here.)    		 Towing:    Yes  No
    Grange Personal Auto Plus:    Yes No
    Rental Reimbursement:    Yes  No
    Note: You must have collision coverage in order to select Rental Reimbursement.
    Loan/Lease Gap:    Yes  No
    Note: Your vehicle can be no more than 3 years old to be eligible for this coverage.
      Anti-lock Brakes:  Yes   No
      Anti-Theft Alarm:  Yes   No
      Airbags:  1   2   None
    Additional Interest, if any: Bank Loan  Leaseholder  None   Other
      Add   Change   Delete
       New Name
       Address
       City/State/Zip
    Inquiry or Other Comments:
              
    Contact Us
    Harris Insurance Agency
    335 Frankfort Road
    Shelbyville, KY 40065

    Telephone:
    (502) 633-2212

    Fax:
    (502) 633-2217

    E-mail Us



    We cannot bind coverage from an email or voicemail request. Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.
    If you have not received a response from us within one business day, please contact us again.

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