June 24, 2017

Replace A Vehicle

*** NOTICE: Coverage cannot be added, altered or cancelled without speaking to an authorized representative of KHT Insurance. We will contact you as soon as possible to complete your request. ***
Policy Information
Name on Policy *
Policy Number
Email *
Phone Number
Fax Number
Confirm by Email  Phone  Fax
Vehicle to Remove
Year *
Make *
Model *
VIN
Vehicle to Add
Year *
Make *
Model *
VIN *
Primary Driver
Owner Information
Name on Title
Ownership Lease  Loan  Own - Paid in Full
Purchase/Lease Date
Loan/Lease Company Name
Address
Address 2
City
State
Zip
Coverage Information
Effective Date of Change *
Coverage Requested * Same as my other vehicles
I'm not sure - please call me
Other
Comments
Comments
* = Required Field
Send
*** NOTICE: Coverage cannot be added, altered or cancelled without speaking to an authorized representative of KHT Insurance. We will contact you as soon as possible to complete your request. ***