Name: Apple Insurance Services
Address: 8817 Belair Road, Baltimore, MD, 21236, US
Telephone: (410) 256-5800

General Information
Name*
Company Name (If For a Business)
Email*
Phone*
Current Insurance Information
Insurance Company Name
Policy Number
Policy Expiration Date
MM slash DD slash YYYY
Date You Would Like Changes to Take Effect
MM slash DD slash YYYY
Type of Change
- Adding a Vehicle
- Removing a Vehicle (Attach Tag Return Receipt from MVA/DMV)
Vehicles
Year Make Model Vin
Purchase Date?
MM slash DD slash YYYY
Who’s the vehicle titled to?
Who’s the primary driver?
Will the vehicle be used for work/school, business or pleasure?
Estimated Annual Miles to be used?
Coverage Selection
- Physical Damage (Full Coverage)
  Deductibles will match your other vehicles on the policy
  We will include roadside assistance
  Rental car coverage will be similar to your type of vehicle
- Liability Only
Full Glass Coverage? ($0 deductible for glass claims)
Lien Holder?
Name Address Purchase or Lease?
Is the vehicle garaged at the address listed on the policy?
Have you returned your tags?
- Yes
- No
Tag Return Date
MM slash DD slash YYYY
Attach Tag Return Receipt from MVA/DMV
Max. file size: 59 MB.
In order to remove a vehicle from your policy, you'll need to return the tags. If you have any questions please call our office 301-985-2667.
Additional comments or questions in regards to this change?
Upload Files
Max. file size: 59 MB.
Request for policy changes submitted through our website, via email or voicemail is not considered binding. You will receive a confirmation email, text, and/or call once the policy change requested has been submitted to the insurance company. An email notification will be sent when the change has been completed. Our turnaround time is typically between 24-48 hours during business days.
Email
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Vehicle Change Request

General Information

Current Insurance Information