Name: Landis Insurance Agency
Address: 1238 West Lincoln Highway, Coatesville, PA, 19320, US
Telephone: (610) 383-1451

Request Type?
- Refinance
- Verification
- Loan Transfer
Customer Name
Policy Number
Vehicle Information:
Vehicle Year
Make
Model
Last 5 of VIN
Effective Date
MM slash DD slash YYYY
Lienholder Name & Address
Requester's Name
Requester's Email address
**If all the needed information has been provided, the requested documents will be emailed within 2 business days. If information is missing, a follow-up email will be sent within 2 business days.**
File
Max. file size: 59 MB.
Additional Information
Email
This field is for validation purposes and should be left unchanged.

Insuring Coatesville & All of Pennsylvania

Call (610) 383-1451