Request an Auto Quote

Please provide the information requested below we will contact you soon with your quote information. If you have any questions, please call us at (818) 657-0500.

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Please enter the vehicle year (for example: 2012)

Please enter the vehicle make (for example: Toyota)

Please enter the vehicle model (for example: Camry)

Ownership

Primary use

Daily mileage

Annual mileage

Security System

Desired comprehensive deductible

Desired collision deductible

Gender

Marital Status

License status

Filing required

Occupation

Current residence

Age when first licensed

Is this person a full-time student with a GPA of 3.0 or better?

Yes

Do you want to add additional drivers to this request?

Yes

Do you want to add additional vehicles to this request?

Yes

Have you had any tickets, accidents, or claims in the past 3 years?

Yes

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Street

City

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Zip Code

Day Phone

Evening Phone

Salzman Insurance

Request an Auto Quote

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Salzman Insurance

Request an Auto Quote

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