To help us supply you with the most accurate car insurance quote possible, please answer as many questions as you can with the most accurate information available to you.
Information submitted will be held confidential and will be used for quote purposes only. Submission of application information in no way obligates you to purchase any product or insurance, nor does it represent any agreement to provide coverage under any insurance policy.
Phone Fax Mail E-mail
Have you or any other driver in your household:
If you answered yes to any of the above questions, please explain:
If the vehicle is kept at an address other than that listed above, please indicate below:
QUESTIONS, COMMENTS OR ADDITIONAL AUTOMOBILE INFORMATION?
Canton & Massillon Ohio's Independent Insurance Agency
210 N. Erie St. Massillon, Ohio 44647
Toll Free: 1-800-852-7276