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Full Name:

Full Address

Phone:

Date of Birth:

Email:

What Are You Driving?

Do you own, lease or finance this vehicle?

Does your vehicle have anti-theft devices?

Yes

New Field:

Alarm Only

VIN Etching In All Windows

Electronic Homing Device

Passive Disabling Device

Active Disabling Device

How Is It Primarily Used?

Estimated Annual Mileage

What's your employment status?

Do you drive for any ride-sharing programs?

Marital Status

How old were you when you got your license?

Have you completed an accident prevention course in the last 3 yrs?

Any motor vehicle accidents or violations in the past 5 years?

Do you currently have auto insurance?

If Yes, Who are you currently with?

How long have you had this policy?

What is your Injury liability limits?

When Does The Policy Expire?

When do need your coverage to start?

Additional Discounts Available

Additional Discounts Available

Automatic Payment

Pay via convenient, automatic withdrawal and save. Bank account and routing numbers are required upon purchasing.

Save up to $17*

Paperless

Enroll in ePolicy to qualify for this discount. With ePolicy, you’ll get your policy and claim documents electronically. After purchase, check your email! You’ll either receive instructions to complete enrollment, or a confirmation that it’s complete if you previously accepted our paperless terms.
Save up to $52*

Don’t risk leaving yourself and your assets unprotected.

Request a free quote now.

516-916-4020

Call The Drake Insurance Agency

GET A QUOTE

Whether you need insurance policies to cover your home or your vehicle in New York, you can work with The Drake Insurance Agency to make sure you get the best coverage.

Location

(516) 916-4020

(631) 557-4680

(212) 324-3025

Our Location

26 Nassau Blvd., Garden City, NY 11530

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Email us

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Office Hours