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Full Name (Format: First name, Last name) - 全名 (格式：名字，姓氏)
*
Gender (性别)
*
Please select at least one option.
Female (女)
Male (男)
Non-binary (无性别)
Address (Street, City, State, Zip Code) - 住址 (街道, 城市, 州, 邮编)
*
Date of Birth (MM/DD/YYYY) - 生日日期 (月份/日期/年份）
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Phone Number - 电话号码
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Email Address - 邮箱地址
*
WeChat ID (if prefer contact via WeChat) - 微信号码 (如果希望通过微信联系)
Marital Status - 婚姻状况
*
Please select at least one option.
Single
Married
Vehicle Year - 汽车年份
*
Vehicle Brand - 汽车品牌
*
Vehicle Model - 汽车型号
Vehicle Vin Number - 汽车Vin号码
Auto Owned/Financed
*
Please select at least one option.
Owned
Financed
Liability Only or Full Coverage (Financed/Leased Vehicle Requires Full Coverage) - 单保或全保 (贷款汽车必须购买全保)
*
Please select at least one option.
Liability Only - 单保
Full Coverage - 全保
Coverage Limit (Basic Limit if No Request) - 保险额度 (没有要求的话默认最基础保额)
Do you have any active auto insurance right now? - 您现在有任何生效中的汽车保险吗？
*
Please select at least one option.
Yes - 有保险
No - 没有保险
Driver License State of Issue and License Number - 驾驶证所在州和驾驶证号码
Driver License Issuance Date (Approximate date if unknown) - 考取美国驾照的日期 (如果不记得请填大概日期)
Another Vehicle Needs Insurance - 需要再加一台汽车
*
Please select at least one option.
Yes - 需要
No - 不需要
Second Vehicle Information (Year, Brand, Model, Vin#, Loan) - 第二台汽车的资料(年份, 品牌, 型号, Vin号码, 贷款)
Additional Driver Needs Insurance - 需要添加其他司机
*
Please select at least one option.
Yes - 需要
No - 不需要
Addition Driver Information (Full name, DOB, Issuance of License, Relationship) - 额外受保人资料 (全名, 生日, 考取驾照日期, 和你的关系)
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