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Dealer Bond - Used Car






















$35,000 Used Car Dealer Bond


USED CAR DEALER BOND
$35,000.00 BOND LIMIT
Please note by submitting this form, you agree that all information is true.
Are you the Owner, Officer or Member?
Required

If you answered "NO", stop and have the Owner, Officer or Member complete the application
Personal Information
First Name
Required
Last Name
Required
Legal Name of Business
Required
DBA Name
Optional
How many years in business under your legal name?
Required
Business Type
Required




E-Mail Address
Required
Mailing Address
Required
City
Required
State
Required
ZIP / Postal Code
Required
Primary Phone Number
Required
Business Street Address
Required
City, State, and ZIP Code
Required
Is the Bond for a start up operation or an existing business?
Required

Owner's Personal Information
Number of Years as a Licensed Dealer?
Required
Owner's Name (Officer or Member)
Required
Owner's SSN for Credit to be obtained
Required
Owner's Date of Birth
Required
Owner Married or Single
Required

Owner's Residence Address
Required
Do you own a Home?
Required

Any Prior Bond Claims for Owner or Business?
Required

Has Owner ever been convicted of a CRIME?
Required

If owners has been convicted of a crime, List Year and Description
Required
How many years experience does Owner have in Dealership Industry?
Required
Any other Officers or Owners of this Business?
Required

If additional Officers or Owners, how many? Enter 0 if none
Required
Do you currently have a Dealer Bond?
Required

If Yes, Name of Bond Carrier. If No, Type "NA"
Required
How did you hear about us? Please let us know
Required
SIGNATURE REQUIRED
I have provided all of the above information for insurance purposes and I state all information is true to the best of my knowledge.
By typing my name warrants my signature.
Required
You agree all information is true to the best of our knowledge and you agree to allow us to obtain your credit history for insurance purposes.
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Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages.  Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company.  If you have any questions, please feel free to contact us.

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