Steer Clear Form PDF Details

Steer Clear Safe Driver Discount is available to policyholders who have young drivers under the age of 25 on their policy who have maintained an accident-free and moving violation-free driving record for the past three years. The young drivers must also have completed educational and driving log requirements in good faith.

The form requires the policyholder or qualifying driver to sign an applicant's statement affirming that they have met the initial requirements for the Steer Clear Safe Driver Discount and understand that they will lose the discount if they are involved in an at-fault accident or receive a moving violation. If the qualifying driver is under the age of 18, a parent, guardian, or named insured must also sign the form.

You'll discover info about the type of form you want to fill out in the table. It will tell you how much time it will require to complete state steer clear form, what parts you will have to fill in, and so forth.

QuestionAnswer
Form NameState Steer Clear Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesstate farm steer clear, state farm steer clear driving program, steer clear discount, state farm insurance steer clear

Form Preview Example

Statement of qualification for Steer Clear® Safe Driver Discount

Policyholder's name

Qualifying driver name(s)

Qualifying driver name(s)

Policy number

Qualifying driver name(s)

Qualifying driver name(s)

STEER CLEAR SAFE DRIVER DISCOUNT INITIAL REQUIREMENTS

(1)All drivers under age 25 have maintained an accident-free and moving violation-free driving record in the past three years.*

(2)All drivers under age 25 have completed the educational and driving log requirements in good faith.

TO MAINTAIN STEER CLEAR SAFE DRIVER DISCOUNT

(1)All drivers under age 25 continue to maintain an accident-free and moving violation-free driving record.*

(2)All drivers under age 25 should complete Second Education material received before their 21st birthday.

Applicant's statement

I have met the initial requirements for the Steer Clear Safe Driver Discount and understand that I will lose the discount if I am involved in an at-fault accident or receive a moving violation.

Signature of qualifying driver

Signature of qualifying driver

Signature of parent/guardian/named insured (if qualifying driver is under age 18)

Agent name

Date (MM/DD/YYYY)

Date (MM/DD/YYYY)

Date (MM/DD/YYYY)

Agent code

*In some states, certain accidents and moving violations may not disqualify you.

1006989

151062.2 03-23-2018

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filling out steer clear state farm step 1

Complete the S for office use only Signature, D for office use only Date, S for office use only Signature, D for office use only Date, Agent name, Agent code, and In some states certain accidents fields with any particulars which may be demanded by the platform.

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