Personal Information Request

California Policyholders Only

Personal Information Request – California Policyholders Only

We ask that you reference our privacy policies. We are happy to provide our California policyholders with personal information as required by the California Consumer Privacy Act (CCPA). Please fill out the below form and we will contact you at the provided email address and/or phone number to verify your identify to meet your request needs. Written requests may be sent to: Grange Insurance Association, 200 Cedar Street, Seattle, WA, 98121.

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Contact Information

First Name

Last Name

Address

Address Line 2

City

State

Zip Code

Phone Number

Policy Information

Policy #

Policy Type

Mortgagee

Vehicle(s) on Policy

Address