Whittemore Insurance, Manchester Londonderry, NH
New Hampshire Auto Insurance Quote

 

Serving the Manchester Londonderry NH area Since 1929

 

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Whittemore Insurance in Londonderry, NH is a local, knowledgeable, service oriented insurance agency that offers personalized insurance packages at competitive prices. Serving the greater Manchester, NH community.
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Auto Quote

If you are, or will be a resident of New Hampshire, please complete the following form if you would like a no obligation quote:

Required fields are in green

First Name:
Last Name:
Address:
City:
State:
  Zip Code: 
Phone:
Evening Phone:
Best time to call:
E-mail:

Have you had current insurance for the last 6 months? Yes No
Do you own a home? Yes No

VEHICLE INFORMATION
Vehicle 1 Vehicle 2 Vehicle 3
Make:
Model:
Year:
VIN (If available)
Is this vehicle used to commute daily?
  Vehicle 1
Yes  No
Vehicle 2
Yes  No
Vehicle 3
Yes  No
If yes, Vehicle 1
how many miles one way:    number of days per week: 
If yes, Vehicle 2
how many miles one way:    number of days per week: 
If yes, Vehicle 3
how many miles one way:    number of days per week: 
Is vehicle used in job beyond commuting?
  Yes  No Yes  No Yes  No
Do you have . . .  Vehicle 1
Air bag  Anti-theft device  Anti-lock brakes
Do you have . . .  Vehicle 2
Air bag  Anti-theft device  Anti-lock brakes
Do you have . . .  Vehicle 3
Air bag  Anti-theft device  Anti-lock brakes

DRIVER INFORMATION
Driver 1
Name:
Date of birth: Married?
Yes No
Sex:
M F
Driver 2
Name:
Date of birth: Married?
Yes No
Sex:
M F
Driver 3
Name:
Date of birth: Married?
Yes No
Sex:
M F

COVERAGE REQUESTED
Coverages
Liability Limits + U.M.
(in 1000's)
25/50 50/100 100/300
250/500 Other
Medical Payments:  5,000 10,000 Other
Property Damage:  50,000 100,000 Other

DEDUCTIBLES

Comprehensive

Collision
Vehicle 1:
Vehicle 2:
Vehicle 3:
Towing Rental Per Disablement
Vehicle 1:
Vehicle 2:
Vehicle 3:

DRIVING RECORD INFORMATION
1. Has any driver in your household had a traffic violation, accident or had their license suspended in the last 5 years? Yes
No
2. Have there been any fire, theft, or vandalism related losses in the past three years? Yes
No
3. Does any student driver have an A or B average? Yes
No
Please explain any "Yes" answers below:

Please note that most of our carriers use insurance scoring which includes obtaining driving records, claims history and credit scores. This information is kept by consumer reporting agencies and is disclosed to others as permitted by law. By submitting your quote request you are authorizing these transactions.

 

 

 

 

Whittemore Insurance
172 Rockingham Road
Londonderry, NH 03053

Toll Free: 800.464.2577
Phone: 603.432.2577
Fax: 603.432.4700

 

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