Auto • Commercial • Umbrella

Get Your Auto & Business Insurance Quote in Minutes

At LifterzLight Insurance, we help families and business owners protect what matters most — without the stress or confusion.
Our licensed agents compare top carriers to find you the best coverage at the best price.

Fast. Simple. No obligation.

“Great coverage doesn’t have to be complicated — we make insurance simple.”

✔ Compare multiple insurance carriers
✔ Save money on Auto & Home bundles
✔ Protection for your business & vehicles
✔ Licensed agents ready to help you nationwide

Applicant Information

First Name *

Last Name *

Date of birth *

Civil Status *

Driver's License #

State Issued

Years Licensed

Email *

Address

Street Address *

City *

State *

Country *

Postal Code *

Driver Information (All Household Drivers)

How many drivers are in the household?

Driver# 1 :Fist name & Last name

DOB

Martial Status

Driver's License #

State Issued

Years Licensed

Relationship to Insured

Occupation

SR-22 Required? (Yes/No)

Driver # 2 First Name & Last name

DOB

Martial Status2

Driver's License #

State Issued

Years Licensed

Relationship to Insured

Occupation

SR-22 Required? (Yes/No)

Driver # 3 First Name & Last name

DOB

Martial Status

Driver's License #

State Issued

Years Licensed

Relationship to Insured

Occupation

SR-22 Required? (Yes/No)

Driver # 4 First Name & Last name

DOB

Martial Status

Driver's License #

State Issued

Years Licensed

Relationship to Insured

Occupation

SR-22 Required? (Yes/No)

Vehicle Information (For Each Vehicle)

Year

Make

Model

VIN

Owenship

Lien Name & Address

Annual Mileage

Primary Use

Garaging Address

COMMERCIAL INSURANCE – Required Information

Business Information

Business Name

EIN

DBA

Structure:

Individual/Sole Proprietor

Partnership

Corporation or LLC

Business Address *

Phone *

Business Operations

Select a business:

How many Employees?

How many Drivers?

Vehicle Make

Model

VIN#

Mileage per Year

Involved in the daily operation of the business?

Yes

No

History (5 Years)

What's your current Insurance Carrier?

What's the Monthly Premium?

Do You Have An Agent Or Assistor?

Yes

No

Upload supporting documents

Please Rate Us

BadGood

Privacy Policy | Terms of Service

Auto • Commercial • Umbrella

Get Your Auto & Business Insurance Quote in Minutes

At LifterzLight Insurance, we help families and business owners protect what matters most — without the stress or confusion.Our licensed agents compare top carriers to find you the best coverage at the best price.

Applicant Information

Driver Information (All Household Drivers)

Vehicle Information (For Each Vehicle)

COMMERCIAL INSURANCE – Required Information

Business Information

Business Operations

History (5 Years)

At LifterzLight Insurance, we help families and business owners protect what matters most — without the stress or confusion.
Our licensed agents compare top carriers to find you the best coverage at the best price.