Recreational Vehicle Estimate Request | Foremost Insurance Group

Primary Applicant

First Name

Last Name

Date of Birth

RV Association Affiliation?

Contact Information

Email Address

Phone Number

Address

Mailing Address

City

State

ZIP Code

Is this the physical address of the RV?

Yes No

Street Address

City

State

ZIP Code

By clicking Agree and submit, you agree to these ESIGN terms and conditions and to receiving marketing calls and text messages as detailed below.

We sometimes call and/or text consumers to provide helpful information about products and services. By clicking Agree and submit, you agree to receive marketing calls and text messages from Farmers^®-related agencies (e.g. Farmers agents listed on www.farmers.com, Farmers General Insurance Agency, Inc., and Kraft Lake Insurance Agency, Inc.) or on behalf of Farmers^®, Foremost^®, Bristol West^®, Toggle^® and Farmers Life^® insurance associated entities and their representatives using an automated telephone dialing system, AI-generated voice, and by artificial or pre-recorded voice, even if your number(s) is/are listed on a national, state, or business do-not-call registry. Consent is not a condition of purchase. You can go to Farmers.com for alternative contact information or texting terms of use. Message and data rates may apply.

RV/Trailer Information

Type of RV:

Date Purchased

Year

Make

Model

Length

Annual Mileage

The purchase price of the RV, including all add on equipment and taxes

In what state is your RV registered?

Business/Ownership Information

Is your RV titled in the name of a business?

Yes No

Is your RV used in connection with any business or profession?

Yes No

Do you share ownership of your RV with anyone other than a spouse?

Yes No

Driver Information

Driver's Name as it appears on license

Date of Birth

Drives the Motor Home percent of the time

Accidents/tickets in past 3 years?

Yes No

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Type:

Date:

State where violation/accident occurred:

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Type:

Date:

State where violation/accident occurred:

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Type:

Date:

State where violation/accident occurred:

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Type:

Date:

State where violation/accident occurred:

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Type:

Date:

State where violation/accident occurred:

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Driver #2 Information

Driver's Name (as it appears on license):

Date of Birth:

Drives the Motor Home percent of the time:

Accidents/tickets in past 3 years?

Yes No

Moving Violations/Accident Information #1

Type:

Date:

State where violation/accident occurred:

Please provide details about this incident:

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Moving Violations/Accident Information #2

Type:

Date:

State where violation/accident occurred:

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Moving Violations/Accident Information #3

Type:

Date:

State where violation/accident occurred:

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Moving Violations/Accident Information #4

Type:

Date:

State where violation/accident occurred:

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Moving Violations/Accident Information #5

Type:

Date:

State where violation/accident occurred:

Please provide details about this incident:

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Driver #3 Information

Driver's Name (as it appears on license):

Date of Birth:

Drives the Motor Home percent of the time:

Accidents/tickets in past 3 years?

Yes No

Moving Violations/Accident Information #1

Type:

Date:

State where violation/accident occurred:

Please provide details about this incident:

Check to add another accident or violation

Moving Violations/Accident Information #2

Type:

Date:

State where violation/accident occurred:

Please provide details about this incident:

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Moving Violations/Accident Information #3

Type:

Date:

State where violation/accident occurred:

Please provide details about this incident:

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Moving Violations/Accident Information #4

Type:

Date:

State where violation/accident occurred:

Please provide details about this incident:

Check to add another accident or violation

Moving Violations/Accident Information #5

Type:

Date:

State where violation/accident occurred:

Please provide details about this incident:

Add another driver

Driver #4 Information

Driver's Name (as it appears on license):

Date of Birth:

Drives the Motor Home percent of the time:

Accidents/tickets in past 3 years?

Yes No

Moving Violations/Accident Information #1

Type:

Date:

State where violation/accident occurred:

Please provide details about this incident:

Check to add another accident or violation

Moving Violations/Accident Information #2

Type:

Date:

State where violation/accident occurred:

Please provide details about this incident:

Check to add another accident or violation

Moving Violations/Accident Information #3

Type:

Date:

State where violation/accident occurred:

Please provide details about this incident:

Check to add another accident or violation

Moving Violations/Accident Information #4

Type:

Date:

State where violation/accident occurred:

Please provide details about this incident:

Check to add another accident or violation

Moving Violations/Accident Information #5

Type:

Date:

State where violation/accident occurred:

Please provide details about this incident:

Has the principal driver owned or driven any motor home more than 12 months?

Yes No

Is any driver required by a state to file proof of financial responsibility?

Yes No

Has any driver had motor vehicle insurance coverage refused or canceled within the past three years? (Not applicable to IL or OH residents)

Yes No

Is the motor home a converted school or public transit bus, step van or delivery vehicle?

Yes No

What insurance company is the RV currently insured with?

Expiration Date:

How would you like us to contact you?

Please tell us what brought you to our website.

If you learned about the program from an ad or other printed piece that lists a four-digit code number, please enter the number here.

Important Notice

The Company will rely on the information provided in this Estimate Request in determining your eligibility, calculating your estimated premium, and ordering consumer reports. If any information is incorrect, incomplete or changes, the corrected, completed or changed information will be used to determine eligibility and calculate your estimated premium.

In connection with this request for estimate of insurance premium, we may review your credit report or obtain or use a credit-based insurance score based on the information contained in that credit report. We may use a third party in connection with the development of your insurance score. Credit reports and other consumer reports may be used either to determine your eligibility for our program(s) or to calculate your estimated premium(s).

No insurance coverage is granted by completing this form or submitting it to the Company. It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages.

If you requested to receive your estimate by mail, please allow four to seven days to receive it. Otherwise, you will receive your estimate next business day by 9 p.m. Eastern time. If you need your insurance estimate sooner, please call the Foremost Insurance Service Center at 888-244-8092, Monday-Friday from 8:30 a.m. to 8 p.m. Eastern time.

Review and submit your request

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RV Insurance Estimate Request

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Important Notice

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