28570 Marguerite Pkw Ste., 110 Mission Viejo, California 92692
     Phone Number: (949) 347-2509   :  Fax Number: (949) 347-2590     
Email Address: contact@hfiinsurancellc.com

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Vehicle Information

Vehicle ownership status
Average one way mileage
Average number of days used per week
Approximate annual mileage
Liability coverage level
Collision deductible
Comprehensive deductible

Driver Information  

* First name
* Last name
* Birthdate
* Gender
* Marital status
Credit rating
Residence status
Years/months at current residence? # of Years # of Months
Age when first licensed
In which state are you currently licensed?
License number (optional)

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