800-231-0965 info@mycararmor.com

Add Gap Only Contract

Make:*
Model:*
Year:*
Miles:*
VIN:*
Member's Name:*
Address:*
City:*
State:*
Zipcode:*
Phone Number:*
Lein Holder:
Email Address:*
Program Cost($):
New Used

AUTOMOTIVE GAP 275
Independent Dealer

Term GAP(275/G)
125% MSRP
AM306
GAP(275/E)
150% MSRP
AM303
0-60 Months $145 $148
61-72 Months $180 $183
73-84 Months $245 $248

Commercial Vehicle Coverage Surcharge: $60.00

Coverage:

Max 150%/125% MSRP

Max paid claim $50,000

Max amount financed $100,000

Max term 84 months

IMPORTANT: A STATEMENT OF NO LOSSES AND A FIFTY DOLLAR($50) LATE FEE(PER CONTRACT) WILL BE REQUIRED FOR ANY APPLICATION REMITTED TO My Car Armor MORE THAN SIXTY(60) DAYS FROM THE AFFECTIVE DATE LISTED ON THE CONTRACT!

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Customer
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Date
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Dealer
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Date
Obligator and Administrator is MyCarArmor or legal name they are registered in each state
Form 268D