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		Recreational Vehicle (RV) Policy Holder Name: First M.I. Last Current Insurance Provider: Do you have a current policy with UIP Insurance Partners?: Yes: No: If Yes, please provide Policy Number and Insurance Provider Policy Number: Insurance Provider: Expiration Date: / / mm/dd/yy Contact Phone No.: E-mail address:     Vehicle Information Year: Type: Conventional (Class A) Camper Van (Class B) Mini Motor Home (Class C) Professional Bus Conversion Non-Professional Bus Conversion    Help Make: Model: Vehicle Use:   Recreational Use-less than 30 days per year Recreational Use-30-150 days per year Primary Residence-used to travel to multiple locations during the year Primary Residence-used in one location during the year           Get the United Advantage Insurance products are available through United Agencies and it's affiliates including UIP Insurance Services, LLC. California Insurance License No.0252636. 2 0 1 0   U I P   I n s u r a n c e   S e r v i c e s ,   L L C.  •  L i c e n s e   N o.  0 2 5 2 6 3 6  •   P r i v a c y   P o l i c y