Classic Auto Insurance from Athena Insurance and Financial Services. Why buy from us? Because we are good at what we do and so are the companies we represent!
Who do we write with? American Collectors, American Modern, J.C. Taylor
Do you want an instant quote immediately? Click on American Collectors link above and get started. Want us to shop for you? Complete the form below and we will shop the three carriers for you at no cost or obligation. Please remember you cannot bind coverage! Thanks.
Would you like to see some cool classics? Would you like to show your car, motorcycle, boat or toy off? Let us know?
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| First name |
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Middle Initial |
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Last name |
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| 2nd name |
Second Name
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Middle Initial |
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Last name |
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| Cell Phone |
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Other Phone |
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email |
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| Mail address |
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City |
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State |
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Zip |
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| Location |
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City |
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State |
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Zip |
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| DRIVER INFORMATION |
| Driver 1 |
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DOB |
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License No. |
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Years licensed |
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| Driver 2 |
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DOB |
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License No. |
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Years licensed |
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| Driver 3 |
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DOB |
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License No. |
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Years Licensed |
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| Driver 4 |
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DOB |
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License No. |
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Years Licensed |
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| DRIVING RECORD & MOVING VIOLATION AND ACCIDENT INFORMATION (for accidents & minors violations go back 3 years. For majors 10 years) |
| Driver 1 |
No. minor violations |
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number of majors |
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number of accidents |
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| Driver 2 |
No. of minor violations |
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number of majors |
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number of accidents |
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| Driver 3 |
No. of minor violations |
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number of majors |
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number of accidents |
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| Driver 4 |
No. of minor violations |
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number of majors |
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number of accidents |
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Vehicle type
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Value veh.1 |
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Vehicle type
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Annual Miles
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Value veh.2 |
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Vehicle type
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Annual Miles
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Value veh.3 |
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| Vehicle 4
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Vehicle type
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Annual Miles
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Value veh.4 |
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| COVERAGES AND LIMITS |
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Property damage
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Medical |
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| Uninsured Motorist BI Limit
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Uninsured motorist property damage
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Rental car coverage |
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Car club |
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Good driver discount |
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Completed accident preventions course |
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All vehicles to be insured stored in garage? |
Please make a selection. |
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| Vehicle 1 |
comprehensive deductible
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collision
deductible
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Roadside service
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Alarm System? |
/ please id
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Minimum number of selections not met.Maximum number of selections exceeded.
Minimum number of selections not met.Maximum number of selections exceeded.
Minimum number of selections not met.Maximum number of selections exceeded.
Minimum number of selections not met.Maximum number of selections exceeded. |
| Vehicle 2 |
comprehensive deductible
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collision
deductible
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Roadside service
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Active Disabling Device? |
/ please id
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| Vehicle 3 |
comprehensive deductible
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collision
deductible
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Roadside service
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Roadside service |
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| Vehicle 4 |
comprehensive deductible
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collision
deductible
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Roadside service
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Roadside service |
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| POSSIBLE DISCOUNT |
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Active disabling device? |
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Passive Disabling Device? |
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VIN Etching? |
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| Vehicle Recovery System |
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Thank you for you taking the time to provide us with the essential information necessary to allow us to shop for the best rates available. Please remember you are not bound at this time. A representative will be in contact with you shortly.For quotes on other type of Vehicles such as Classic Auto, Recreational Vehicles or Marine please use use the appropriate keyword to search for the forms or call our office. We can assist you in the completion of these forms. Have a nice day. |
| We will do the comparison shopping and discuss some carrier options with you. |
Note! If your submission does not redirect you to a "Success page" scan application for missing responses.
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