Add a Driver - Yakima Valley Insurance

Name of driver to be added*
First Last
Does this driver reside in your household?*
If away at school answer 'Yes'
- Yes
- No
Date of Birth*
Month
Day
Year
Relation to Named Insured (You)*
Drivers License Status*
Is an SR-22 required?*
- No
- Yes
- Not Sure
Drivers License Number*
Permit Number*
Is this driver a student*
- No
- Yes
Does this driver have a 3.0 or higher GPA
- No
- Yes
Upload proof of Good Student Discount
Acceptable proof is a most recent grade report or transcript. ***If not available, please continue to complete the form.***
Max. file size: 128 MB.
Leave any special requests here.
Requester Email*
Warning
Warning: It is a crime to knowingly provide false, incomplete, or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines, and denial of insurance benefits. Any accident involving a driver not on your policy, may not be covered. You must be the Named Insured on the policy to submit a policy change request.

Add a Driver in 2 Easy Steps