Collector Vehicle Certificate of Collectability Application

NSM Insurance Group is a leader in industry-specific insurance programs. Our Collector Car Division provides insurance solutions specially tailored for collectors. We proudly represent American Collectors Insurance, Condon Skelly, and Heacock Classic insurance brands.

Name*

Mailing Street Address*

Mailing City*

Mailing State*

Mailing Zip Code*

Email Address*

Year*

Make*

Model*

VIN*

Type of Vehicle*

Select

Estimated Value of Collector Vehicle*

Please list any awards / designations your collector vehicle has earned.

Story

Why is your vehicle special / unique?

Please upload at least two (2) photos of vehicle exterior and two (2) photos of vehicle interior + other documentation to consider*

Please ensure entire vehicle is visible in exterior photos

Drag and drop files here or

Current Collector Car Insurer*

Select

If you selected "other" above, please list which company insures your collector vehicle

Policy Number

For insurance coverage verification

Allow use of information and images provided above for promotional purposes

Send promotional content such as the certificate

Send me a copy of my responses

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