Change of Name

---

Existing Policy: Change of Name
Contact Information:
	Your Full Name: (as listed on policy now)
	Your Email Address:
	Daytime Telephone Number:
	Policy Number:
Change Request:
	Your FORMER Name:
	Your NEW Name:
	Reason for Name Change:
	Additional Comments:
	Questions:
Please Note: Insurance coverage cannot be bound without a written binder from our office.

 

 

---

Useful Worksheets for Home & Auto

1. Auto Accident Report Form - (to keep in glove box)-PDF
2. Home Inventory Form - (complete before a loss occurs)-PDF
3. Memory Jogger - (for use with home inventory worksheet.)-PDF

---

Brier Payne Meade, Topeka – (785) 233-1717
Brier Payne Meade, Kansas City – (913) 402-9576

Get Driving Direction To Our Locations