Mailing Address Change Service Request Form

Mailing Address Change Request Form

"*" indicates required fields

What is your name?*

Email*

Phone Number*

What is your Physical Address?*

Street Address Address Line 2 City State ZIP Code

What is the new Mailing Address?*

Street Address Address Line 2 City State ZIP Code

What is the date you would like to see this change effective? (Request only, not confirmation.)*

Please affirm below that you understand this request is not confirmed until you receive confirmation from the agency or carrier.*

First Choice

Second Choice

Third Choice

Our Mission

Our mission is simply stated, yet earnest. We provide families and business owners peace of mind by safeguarding their assets through risk management expertise. Our proven process ensures you understand your risk tolerance while feeling informed, educated, and protected.

How Can We Help?

Wayzata

1907 Wayzata Blvd Ste 210,
Wayzata, MN 55391

Call or Text

952-930-3661

Hours

Mon. – Thurs.: 8:00 am – 4:30 pm
Friday 8:00 am – 2:00 pm

Coon Rapids

8960 Springbrook Drive, Suite 100
Coon Rapids, MN 55433

Call or Text

763-755-7000

Hours

Mon. – Thurs.: 8:00 am – 4:30 pm
Friday 8:00 am – 2:00 pm