Auto Rental Preliminary Insurance Survey
PROSPECTIVE PRODUCERS: If you are a producer and are not currently approved to submit business to Lancer, please do not submit this form. Instead, complete the Producer Response Request Form and we'll get back to you promptly.
PROSPECTIVE POLICYHOLDERS: This survey creates no express or implied obligation on our part to offer a quote or provide insurance as requested. We may request you to complete a more detailed application with the assistance of a Lancer authorized insurance producer.
Please answer all questions completely:
The Survey is copyrighted and material appearing within may not be reproduced in any form without the written permission of Lancer Insurance Company. All Rights Reserved.