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Top 5 Reasons Why You Should Use Scislow Financial Services, Inc. Services:

1. The best Minnesota Insurance Plans at the lowest price.

2. Instant phone quotes for most products.

3. Low monthly installments available on many plans.

4. Internet quotes returned within 24 business hours.

5. Rates are shopped exclusively for you. Our experience allows us to match you with the program that best meets your needs.

your satisfaction is guaranteed by the Ed Scislow Agency!

 
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MN Insurance quotes

On-Line Motorcycle
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!
YOUR PERSONAL DATA:

Your Name:
Street Address:
City:
State: (Must be Minnesota)
Zip/Postal:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
 
Marital Status:
Single Married
Homeowner?
Yes No
 
Currently Insured?
(If yes, list carrier, and # of years
continuous. If no, type NONE)

 
DRIVER INFORMATION #1
Name: Birthdate:
Sex: # Years U.S.
 Auto License:
Cycle Safety Course? # Years U.S.
 Cycle License:
Number & Type of
Accidents within
last 3 years:		 Number & Type of
MINOR violations within
last 3 years:
Number & Type of
MAJOR violations within
last 3 years:		 Daily commute
in ONE WAY miles:
Does Driver need
an SR22 FILING?		 Yes No Comments or
Remarks?
 
DRIVER INFORMATION #2 (if none, leave blank)
Name: Birthdate:
Sex: # Years U.S.
 Auto License:
Cycle Safety Course? # Years U.S.
 Cycle License:
Number & Type of
Accidents within
last 3 years:		 Number & Type of
MINOR violations within
last 3 years:
Number & Type of
MAJOR violations within
last 3 years:		 Daily commute
in ONE WAY miles:
Does Driver need
an SR22 FILING?		 Yes No Comments or
Remarks?

VEHICLE #1 INFORMATION
Year of vehicle: Make & Model:
Is this a 4 Wheeler?: If Yes, Describe:
Annual Mileage: # of CC's:
Value of Bike: $ Special Equipment Value: $
VEHICLE #1 COVERAGES:
Limits of
Liability:		 $15/30 BI / 10 PD
$25/50 BI / 15 PD
$50/100 BI / 50 PD
$100/300 BI / 50 PD
 
Comprehensive
& Collision:		 NO Coverage $250 Deductible
$500 Deductible $1000 Deductible
 
Do you want
Medical Coverage?		 Yes No   Uninsured
  Motorists Cov.?		 Yes No
 
VEHICLE #2 INFORMATION (if none, leave blank)
Year of vehicle: Make & Model:
Is this a 4 Wheeler?: If Yes, Describe:
Annual Mileage: # of CC's:
Value of Bike: $ Special Equipment Value: $
VEHICLE #2 COVERAGES:
Limits of
Liability:		 $15/30 BI / 10 PD
$25/50 BI / 15 PD
$50/100 BI / 50 PD
$100/300 BI / 50 PD
 
Comprehensive
& Collision:		 NO Coverage $250 Deductible
$500 Deductible $1000 Deductible
 
Do you want
Medical Coverage?		 Yes No   Uninsured
  Motorists Cov.?		 Yes No

Send my quotation via: E-Mail Fax
Regular Mail
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Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a
Motorcycle Quote NOW!

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You may contact our agency at either of our convenient
Minnesota office locations below:
Scislow Financial Services, Inc.
 12904 Nicollet Ave. S. - Burnsville, MN 55337
Phone: 952-894-8382 | Toll Free: 877-894-8383

8400 Lyndale Ave. S., Suite 5 - Bloomington, MN 55420
Phone: 952-934-2268

E-Mail us at: lowrates@mninsurancewebsales.com