Georgia Home and Auto Insurance - Insurance Service Request

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770-434-6691

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5 Reasons Why You Should Use Our Insurance Services:

1. Excellent coverage at very competitive prices.

2. FAST online quotations for auto, homeowners, and life, and INSTANT quotes by phone.

3. Low down payment & Easy monthly installments on most policies.

4. Our service is second to none. Call us and get an agent who really CARES!

5. We offer a satisfaction guarantee. We know our top quality coverages and service will SATISFY you!

Remember...
"All Our Policies Come With an Agent!"

Clemmons Insurance Agencies has helped thousands of Georgia, Tennessee, South Carolina, and Missouri residents and businesses find the lowest rates available and the best insurance plans to protect their cars, homes, businesses, and families. Let us do the same for YOU! Our office includes a state-of-the-art computer system for policy services, claim servicing and accounting so that quality service is GUARANTEED. Your needs will be addressed, phone calls returned, and coverage issues responded to, and claim matters will be addressed...WITHIN 24 HOURS!

Insurance Service, Claim Report, or Certificate of Insurance Online Request Form One Simple Form - takes only 2-3 Minutes! Your Personal Data
Your Name
Street Address:
City:
State:
Zip/Postal:
E-Mail (REQUIRED):
Phone (REQUIRED):
Fax: (Optional)

Policy & Service Details
Your Policy Number:


What do You Need?	Policy change Insurance Certificate Claim Assistance Other


If Change of Bank, List Bank Loan #, and Full Insurance Mailing address here (and any remarks):

If Change of Car, List Full Year, Make, Model, Purchase Price, and Vehicle ID# Here (also let us know if additional car, or replacement & which car to remove):

If You Are Reporting a Claim, Give us AS MANY DETAILS as you Can (including witnesses, police report #, and anything else you may have.):

If You Are Requesting a Certificate of Insurance, give us name and address (and fax#) of party requesting it.

If You Are Requesting a Certificate of Insurance, Please give us job details and other info we may need.

Describe Any Other Service Need You Have, in DETAIL:

Please contact me for service via:	Fax E-Mail Regular Mail Please Call Me!

Thank you for filling out this form COMPLETELY!
We deem your data submitted as PRIVATE information. Every step has been taken to insure your privacy, security, and to release this information only to you. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release them from any liability should this information be accidentally viewed by others. Also, the insurance carriers reserve the right to issue coverage or not, and we cannot guarantee acceptance of a risk until approved by the company.
Yes, Please Service My Account. I Understand that NO COVERAGE IS BOUND on insurance changes until confirmed IN WRITING BY OUR AGENCY.

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GA auto insurance

Please contact our agency at the address and phone numbers below for a free quotation today. We have the service you are looking for!
Clemmons Insurance Agencies - Smyrna, GA Office
1326 Concord Road, Smyrna, GA 30080
Phone: 770-434-6691
Fax: 770-434-6779
Email: Click Here to Email Us | Click for Map/Directions
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