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Quote Request – Auto Insurance – Germany – geico
1
Personal Information
2
Vehicle Information
3
Coverage & Submit
1/3
Personal Information
I understand that this insurance is not intended for rental cars, nor for covering your (US) car for holidays / vacation in Germany.*
First Name
*
Last Name
*
Personal Email
*
Phone Number
*
Are you affiliated with US/NATO Forces?
*
Yes
No
Where will the vehicle be registered?
*
USAREUR
German registry
Duty Station/Location in Germany
*
Are you married?
*
Yes
No
Date of Birth
*
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Are you currently insured with GEICO?
Yes
No
GEICO policy number
Car Make
*
Car Model
*
Year of Vehicle
*
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2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
VIN - Vehicle Identification Number
Horse Power
Actual Cash Value in USD
*
(max. value 95,000 USD)
2nd Driver Information
2nd Driver First Name
2nd Driver Last Name
Is there a lien on your vehicle?
Yes
No
Lienholder Name:
Lienholder Address:
Have you had any at-fault accidents in the last five years?
Yes
No
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Third Party Liability Insurance incl. Motor Assistance Coverage (mandatory)
*
Yes
Comprehensive Coverage (e.g. theft, broken windshield, natural hazard) Deductible 300 EUR
*
Yes
No
Collision Coverage (own damage) Deductible 500 EUR (Note: If you select to have Collision Coverage, you will also carry Comprehensive Coverage with a 300 EUR deductible)
*
Yes
No
Loyalty Repair Program?
*
Yes
No
Effective Date of Coverage
*
PCS Date / DEROS
I hereby consent to my data submitted in the contact form being collected and processed in order to answer my request.
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