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About
Contact
Map
Get A Quote
EZ Auto Tags & Notary

Antique Auto Insurance Quote Form

your information

Name:

Email*

Full Address:

Birthdate (00/00/0000):

Sex (M/F):

Marital Status (Single or Married):

Daily commute in ONE WAY miles:

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VEHICLE #1 INFORMATION

Email*

Year, Make, & Model:

Where is Vehicle Kept, please describe:

Liability Limits:

Do you want Medical Coverage (Yes or No):

Uninsured Motorists Cov. (Yes or No):

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VEHICLE #2 INFORMATION

Email*

Year, Make, & Model:

Where is Vehicle Kept, please describe:

Liability Limits:

Do you want Medical Coverage (Yes or No):

Uninsured Motorists Cov. (Yes or No):

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sterling insurance agency

Mailing Address: Sterling Auto Ins. 6908 Bristol-Emilie Road Baily's Plaza, Levittown, PA, 19057

PA Insurance License #: 55812