Quick Auto Quote

Auto insurance · about 10 minutes · no obligation

Fastest option: snap a photo of your current auto declarations page and email it to us with your name — that covers most of this automatically. Otherwise, fill in what you can below. Only a few fields are required (marked *).

Your Info

Full name

Date of birth

Phone

Home / mailing address

Marital status

Spouse / domestic partner / significant other — name (if any)

Their date of birth

Current Insurance

Current auto carrier

Drivers

Vehicles

Quick checks

Any driver with a DUI, or a suspended/revoked license?

NoYes

Any vehicle used for rideshare, delivery, or business?

NoYes

Any salvage-title or heavily modified vehicles?

NoYes

Claims History

Any auto claims, accidents, or tickets in the last 5 years? Briefly what & when.

Anything else we should know?

Anything else to insure?

Check anything you'd like us to quote too — no obligation.

Umbrella / extra liability Life insurance Motorcycle Boat / watercraft Jet ski / PWC ATV / UTV / side-by-side Snowmobile RV / motorhome Camper / travel trailer Golf cart Classic / collector car Home / renters Jewelry / watches Firearms / guns

Other — tell us what

Leave this field blank

Your summary:

"Submit" sends this straight to our agency — no email app needed. Attach a dec-page photo separately by replying to our confirmation, or use "Email instead" if you'd rather send it yourself.

Shield Insurance · Mulligan Agency Branch · Hudsonville, MI
Questions? Email Ryanm@shieldagency.com