Contact Us

Broker License #0516723

Call Us at:
(800) 345-4701 or (619) 428-4714

Opening Hours:
7:00am – 11:00PM PST
7 Days A Week

Let Us Know if You Have Questions

INSTANT MEXICO AUTO INSURANCE SERVICES

Name

Tel

FAX

ADDRESS

LIEN HOLDER (if applicable)

ACCT #

FAX TO

CLUB MEMBERSHIP NO(if applicable)

Do you have a passport

Yes No

I want to purchase a Mexican Auto Insurance Policy for:

Starting from:

To:

At:

Vehicle: (Year - Make - Model - Vehicle ID No.)

Trailer: (Year - Make - Model - Trailer ID No.)

Boat: (Year - Make - Model - Boat ID No.)

Motorcycle: (Year - Make - Model - Motorcycle ID No.)

Vehicle pulled by Motorhome: (Year - Make - Model - Vehicle ID No.)

COVERAGE: Choose a plan:

PLAN 1
-Collision
-Fire & Theft
-Liability - (PD, PL * Medcal)
-Legal Services (Optional) PLAN 2
-Liability - (PD, PL * Medcal)
-Legal Services (Optional)

ACTUAL CASH VALUE OF: (if full coverage desired)

Vehicle: $

Trailer: $

Boat: $

Motorcycle: $

Vehicle pulled by Motorhome: $

Other: $

Fishing Permit

Boat Permit

Length

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