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Auto Quote Form


Finding the most affordable Auto Insurance, while providing the maximum coverage is the top priority for most Drivers.  We give you the information you need to get the best Car Insurance in Pennsylvania so you can save time and money by using an online insurance quote form.

We can find the best Car insurance for your needs and save you money. We provide Auto Protection in the Pittsburgh, Pennsylvania and surrounding areas. 

Complete our 3 minute quote form and get rates, coverages and discounts on Car insurance in the Pittsburgh, Pennsylvania and surrounding areas.  
Your Agent: Ron Gaab       
 Start my Free Quote!                                                                                                 Email: giz@stoskel.com     
Phone: 724-225-8344  
All information provided will be kept safe & secure and will only be used to provide quotes for  insurance products you are looking for.   

Your PA Home Insurance on it's way!

First Name
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Last Name
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Street
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City
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State
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ZIP / Postal Code
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Primary Phone Number
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E-Mail Address
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Best time to call
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Currently Insured
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Current Insurance Provider
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Years/Months Continuously Insured
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Current Policy End Date
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Credit Rating
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Residence
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Driver Information
Name of Driver (First, Last)
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Date of Birth
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Gender
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Education
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Occupation
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Age
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Marital Status
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License State
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License Status
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Age Licensed
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Suspension (5 yrs)
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Spouse
Name of Driver
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Date of Birth
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Gender
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Education
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Occupation
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Age
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Marital Status
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License State
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License Status
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Age Licensed
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Suspension (5 yrs)
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Any other drivers in the household?
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Violation and Accident Information
Please list any Accidents in the last 3 years
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Please list any tickets or Violations in the past 3 years
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Vehicle #1
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VIN #
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Usage
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If for work, # of miles each way to work
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Annual Miles Vehicle 1
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Primary Driver
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Anti-lock brakes?
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Security system?
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Air bag/Seat belts?
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Comprehensive Deductible
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Collision Deductible
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Vehicle #2
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VIN #
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Usage
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select
If for work, # of miles each way to work
Optional
Annual Miles Vehicle 2
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Primary Driver
Optional
Anti-lock brakes?
Optional
select
Security system?
Optional
select
Air bag/Seat belts?
Optional
select
Comprehensive Deductible
Optional
select
Collision Deductible
Optional
select
Vehicle #3
Optional
select
VIN #
Optional
Usage
Optional
select
If for work, # of miles each way to work
Optional
Annual Miles Vehicle 3
Optional
Primary Driver
Optional
Anti-lock brakes?
Optional
select
Security system?
Optional
select
Air bag/Seat belts?
Optional
select
Comprehensive Deductible
Optional
select
Collision Deductible
Optional
select
Coverage Options
Bodily Injury Liability
Required
select
Property Damage Liablility
Required
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Uninsured Motorist Bodily Injury
Optional
Uninsured Motorist Property Damage
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Underinsured Motorist Property Damage
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Medical Pay / PIP
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Full Tort or Limited Tort?
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We value your input as PRIVATE information. Every step has been taken to insure your privacy & security. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes
Thank you
We will be contacting you shortly with an Auto Insurance Quote from Stoskel Insurance. If you prefer you can call us at 724.225.8344 or visit us at www.stoskel.com
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We value your input as PRIVATE information. Every step has been taken to insure your privacy & security. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes.

Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages.  Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company.  If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.



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