Car Change

Car Change Form

Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

"*" indicates required fields

Name*

First Middle Last

Phone*

Email*

Enter Email Confirm Email

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Registered Owner*

First Last

Effective Date*

Vehicle Year*

Vehicle Make*

Vehicle Model*

VIN*

Buy or Lease?*

Transferring Plates?*

Lienholder (Bank)*

Lienholder Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Switching From Which Vehicle?

Dealer Name*

Dealer Phone*

Dealer Email*

CAPTCHA

This field is for validation purposes and should be left unchanged.

The Getzoni Agency has been proudly serving the Buffalo and the Western New York area for over 40 years. We carry the strongest insurance lines that can support your claims while providing superior customer support and local service.

Car Change

Car Change Form

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Contact Us

1 (716) 631-0363

info@buffaloinsurance.com