How can we help you?

Are you a current client of our agency?*
- Yes
- No
What policy number(s) do you need help with if available?
What is the nature of your inquiry?*
- General Question
- ID Card Request
- Policy Change Request
- Discuss A Claim
- Certificate of Insurance
Describe your policy change request
What date do you need this policy change/request to take effect?*
DD slash MM slash YYYY
Which vehicle do you need an ID card for (please enter year, make, and model)?
Year Make Model
Your Name*
First Last
Your Email*
Your Phone
SMS Opt-in Consent*
Disclaimer: By choosing "Yes" and submitting this form, you consent to receive SMS messages from Schmit Insurance Group at (507) 458-0007 about account notification, customer care or marketing. Message frequency may vary, and standard messaging and data rates may apply. Reply STOP to unsubscribe or HELP for assistance. For more details, see our Terms of Service and Privacy Policy and https://www.schmitinsurance.com
- Yes – I’m okay with texts from Schmit Insurance Group. No marketing, just the important stuff.
- No - I do not want to receive any kind of texts from Schmit Insurance Group.
Please list the Additional Insured and/or Certificate Holder
Additional Insured and/or Certificate Holder Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Details regarding your question, policy change, claim or other request:*

Winona location

Wabasha Location

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Year	Make	Model