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Request Service

Commercial Lines Forms

JGP CL - Information to Quote WC (116.8 KiB)

JGP CL Add Certificate Holder Request Form (67.6 KiB)

JGP CL Add Equipment Request Form (49.1 KiB)

JGP CL Add Location Request Form (66.4 KiB)

JGP CL Add Vehicle Request Form (69.1 KiB)

JGP CL Business Income Worksheet (45.5 KiB)

Personal Lines Forms

JGP PL Auto Policy Change Request Form (91.7 KiB)

JGP PL Auto Quote Questionnaire (144.4 KiB)

JGP PL Boat Quote Questionnaire (152.9 KiB)

JGP PL HO-Dwelling Fire Change Request (95.5 KiB)

JGP PL Young Driver Questionnaire (153.3 KiB)

PL Auto Accident Information Exchange & Witness Information (70.2 KiB)

PL Bathroom Construction Quality Checklist (138.3 KiB)

PL COC & Replacement Cost Worksheet (384.6 KiB)

PL Kitchen Construction Quality Checklist (109.1 KiB)

PL Motorcycle-Off Road Questionnaire (149.2 KiB)

State of CA Forms

CA Form 601 - Notification of Ownership Change or Combinability of Entities (252.3 KiB)

CA Residing Relatives Form (28.8 KiB)

CA Workers Comp DWCForm1.Notice of Potential Eligibility (161.7 KiB)

Federal Forms

IRS ERM-14 Form - Request for Ownership Info (431.7 KiB)

IRS W9 Form - Request for Taxpayer Identification Number (61.1 KiB)

Other Misc. Forms

Accident Eyewitness Statement (138.5 KiB)

Statement Of No Loss (84.9 KiB)

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  • Need help with filling out a form?

    Department contact information is found at the top of each form. For quicker service, send completed form directly to your account service team either by fax or email.

    You have two options for completing and forwarding service request forms found on this page:

    Option 1.     Fill out the form on our website, save a copy to your computer. Print form and fax to our office or email form directly from your computer.

    Option 2.     Print form from our website, fill out form in ink, fax form to our office.

    Keeping a copy of the Accident Eyewitness Statement or Accident Information & Exchange Witness Information form in every car you own, along with a disposable camera (if the driver does not have access to a cell phone with the camera feature) is highly recommended. The information gathered is crucial to providing claims adjusters with important facts of an accident.

    - About "House Types"

Copyright © 2011 James G Parker Insurance Associates. All rights reserved. License #0554959