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For you convenience, Bean Insurance Agency can process coverage for your new car online. Please note that online requests will be processed during normal business hours.

Remember that no coverage is bound until you have received either written or verbal confirmation from Bean Insurance Agency.

Your Name:

Contact Email:

Contact Phone:

Contact Address:

Please provide the following information about your car:

Year

Make:

Model:

Cost New:

Primary Intended Use:

Lienholder Name & Address:

Effective Date of Change/Addition:


Please let us know whether you want per policy limits (include amounts) or liability only for your coverage:




Bean Insurance Agency LLC | Independent NH Insurance Agency
151 Winnacunnet Road, P.O. Box 660
Hampton, NH 03843
Phone: 800.660.BEAN Email: info@beaninsurance.com



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