• 
• 
  • History
  • Staff
• 
  • Auto
  • Home
  • Life
  • Specialty
• 
• 
• 
• 
• 
• 
• 
  • Auto
  • Home
  • Life
• 
•  

Get a Quote - Auto Insurance

*Please Note* - Farnham Insurance is licensed to sell insurance in Pennsylvania only, and primarily in Cumberland, Dauphin, Perry, Adams, York, Lancaster, and Lebanon Counties.

Personal Information
First Name: *
Middle Name: *
Last Name:
Date of Birth: *
Address: *
Address 2:
City: *
State: *
Zip: *
Phone Number:
Email Address: *
Vehicle Information
Vehicle Make: *
Model: *
Year: *
Vehicle Usage
Work:         Business:       Pleasure:
Miles Driven 1 way: *

Accidents/Violations in the last 3 Years?	Yes       No
# of Accidents       # of Violations
Coverage Requested
Limits Requested:	Bodily Injury - 250/500 Bodily Injury - 100/300 Bodily Injury - 50/100 Bodily Injury - 25/50 Bodily Injury - 15/30 Property Damage - 100,000 Property Damage - 50,000 Property Damage - 25,000 Property Damage - 10,000 Property Damage - 5,000 Full Tort Limited Tort Collision Deductable - None Collision Deductible - 1000 Collision Deductable - 500 Collision Deductable - 250 Comprehensive - None Comprehensive - 500 Comprehensive - 250 Comprehensive - 100 First Party Medical - 100,000 First Party Medical - 50,000 First Party Medical - 25,000 First Party Medical - 10,000 First Party Medical - 5,000
Additional Coverages:	Funeral Accidental Death Income Loss Uninsured/Underinsured Motorist Towing Vehicle Rental
Questions/Comments:
Verify:	In order to minimize abuse/spam, please enter the text you see into the input field below. Numbers only. Enter code below as shown: