Insurance 411

YOUR INFORMATION Your Name: Emergency Contact: Emergency Phone:

Welcome to Insurance 411, a tool to help you keep all of your insurance recovery information at your fingertips in the event of an emergency. By taking a few minutes to consolidate your insurance policy and contact information on this form, you can print out a credit card-sized information sheet to carry in your wallet. Privacy: IINC respects your privacy. It cannot access the information for your Insurance 411 card. When you are done printing, simply close the browser to delete.

HOMEOWNERS INSURANCE Company: Policy #: Agent: Claims Phone: Web URL:

EARTHQUAKE INSURANCE Company: Policy #: Agent: Claims Phone: Web URL:

FLOOD INSURANCE Company: Policy #: Agent: Claims Phone: Web URL:

AUTO INSURANCE Company: Policy #: Agent: Claims Phone: Web URL:

OTHER INSURANCE Company: Policy #: Agent: Claims Phone: Web URL:

PRIVACY Absolutely no information entered will be retained, accessed or shared and is for personal printing purposes only.

Insurance 411 is a product of the Insurance Information Network of California, a non-profit association dedicated to helping consumers
understand insurance and manage risk. Please visit us on the Web at www.iinc.org.