Add or Remove Driver to Existing Policy Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly Add or Remove Driver Policy Holder Information First Name* Last Name* Street* City* State* Zip / Postal Code* Primary Phone Number*Alternate Phone NumberE-Mail Address* Policy Number* Current Insurance Provider: Add or Remove a Driver Information* Add a Driver - New Driver Information Remove a Driver - Driver Information Add a Driver - New Driver Information Name of Driver (First, Last)* Gender*MaleFemaleMarital Status*SingleMarriedSeparatedDivorcedWidowedWhen will this change take effect?* MM slash DD slash YYYY Relationship*SpouseChildRelativeParentNon-RelativeLicense State* License Number* Date of Birth* MM slash DD slash YYYY Does this driver have any major violations (5yrs), accidents or minor violations (3yrs), comprehensive or collision claims (3yrs)?Not SureYesNoRemove Driver from Existing Auto Policy Remove a Driver Driver Information Name of Driver (First, Last): When will this change take effect?: MM slash DD slash YYYY DISCLAIMER: Any changes expressed over the internet can only be honored after Ford Insurance Agency, Inc has acknowledged the receipt of the change and after underwriting approval. Changes expressed in emails or messages are not bound automatically. All changes are subject to verification and underwriting approval. Customer Service hours at Ford Insurance Agency, Inc are Monday-Friday 9-5:00 PM. (closed for lunch 12-1pm)CAPTCHAEmailThis field is for validation purposes and should be left unchanged. Resource Menu File a Claim / Make a Payment Certificate of Insurance Request Form Add / Remove a Driver Add / Remove Vehicle to Auto Policy Refer a Friend Auto I.D. Card Request Form FAQ’s