Request DL-123e

Required by the North Carolina DMV.

Please watch this video with your new driver. We also encourage you to bring your new driver in for an insurance “pep” talk!

Fill out the required information and we will be in touch with the next steps.

Your Full Name*
First Middle Last
Are you requesting a DL-123e on behalf of someone other than yourself?*
- Yes
- No
Full Name of Recipient*
First Middle Last
Name of the person who needs proof of insurance.
Date of Birth*
Date Format: MM slash DD slash YYYY

Date of birth for the person on the DL-123e.
Your Email*
Your Phone Number*
Coverage will not be bound or changed until confirmed by a licensed agent.
This field is for validation purposes and should be left unchanged.