Name: Affinity Insurance Group
Address: 800 W Williams St, Apex, NC, 27502, US
Telephone: (919) 296-3787

Effective Date: 05/07/2025

Introduction

At Affinity Insurance Group LLC, your privacy is important. This Privacy Policy outlines how we collect, use, disclose, and protect your information when you apply for or inquire about auto, home, business, or life insurance coverage through us.

Information We Collect

In the course of providing insurance quotes and services, we collect the following types of information:

Personal Identifying Information: Full name, date of birth, address, phone number, email, driver’s license number and required for business insurance either tax identification number or Social Security number.
Property & Risk Information: Vehicle details, home or property characteristics, business operations data, and other risk-related information.
Financial Information: Credit based insurance scores (where permitted and required by insurers – this is a soft inquiry, which does not affect your credit score), payment information, and insurance history.
Health Information: For life insurance policies, we may collect relevant medical or health-related information (with your explicit consent). You may also provide this information by phone or email if you prefer.
Usage Information: Data from our website (e.g., IP address, device info, browsing behavior).

How We Use Your Information

We use the collected information to:

Generate accurate insurance quotes
Process policy applications and renewals
Evaluate risks and underwrite policies
Communicate with you about services, claims, billing, and policy changes
Comply with regulatory requirements

Prevent fraud or unauthorized access

Sharing Your Information

We may share your information with:

Insurance carriers and underwriters to obtain quotes or issue policies
Third-party service providers assisting in IT, claims, compliance, and customer support
Government agencies or regulators as required by law
Affiliated partners for servicing policies or providing related services (e.g., roadside assistance)

We do not sell your personal information to third parties.

Safeguarding Your Information

We implement administrative, technical, and physical safeguards to protect your data. This includes encryption, secure servers, and restricted access protocols.

Your Rights and Choices

You may:

Access or correct your personal information
Request deletion of data, subject to retention requirements
Opt out of non-essential marketing communications

To exercise these rights, contact us at info@affinityinsurancenc.com

Retention of Information

We retain your data only as long as necessary to provide services and fulfill legal or regulatory obligations, including insurance recordkeeping laws.

Children’s Privacy

Our services are not directed to children under 13. We do not knowingly collect data from minors without verifiable parental consent.

Updates to This Policy

We may modify this Privacy Policy periodically. Updates will be posted on this page with a revised effective date.

Contact Us

For questions about this policy or to request changes to your information, please contact:

Affinity Insurance Group
info@affinityinsurancenc.com
(919) 296-3787
800 W Williams St
Suite 231H
Apex, NC 27502

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First Name*
Last Name*
Email*
Phone*
Date Of Birth (MM/DD/YYYY)*
Do You Currently Have Active Policies With Us?*
For new clients home quote requests, we require auto insurance to be included in the bundle.
Preferred Contact Method
Type of Insurance*
Type of Insurance*
North Carolina Consent*
I certify that I reside in North Carolina, am relocating to the state, or own property or a registered business within North Carolina.
Terms and Conditions*
I acknowledge that by checking this box, I agree to the Privacy Policy and the Terms and Conditions of the service.
Property Address to Quote
Street Address*
Second Address Line (Suite, Apartment, or Building #)
City*
State*
Zip Code*
Is This Address Also The Mailing Address?*
Mailing Address (Street Address/City/State/Zip Code)*
Desired coverage effective date (MM/DD/YYYY)*
Homeowners Insurance
Do you currently have homeowners insurance?*
Current Insurance Company
Policy expiration date (MM/DD/YYYY)
Do you have a current homeowners insurance declaration page?*
Please upload it here:
Drop files here or

Max. file size: 59 MB.
Others Listed on Deed:*
Number Of Extra Persons Listed On Deed*
First Additional Person Listed On Deed
First Name*
Last Name*
Date Of Birth (MM/DD/YYYY)*
Second Additional Person Listed On Deed
First Name*
Last Name*
Date Of Birth (MM/DD/YYYY)*
Third Additional Person Listed On Deed
First Name*
Last Name*
Date Of Birth (MM/DD/YYYY)*
Homeowners Insurance Information
For How Long You Have Been At This Property?*
Prior Property Street Address*
Prior Property Second Address Line (Suite, Apartment, or Building #)
Prior Property City*
Prior Property State*
Prior Property Zip Code*
Is this your primary residence?*
Year property was built*
Purchase Price $
Type Of Property*
Square footage*
Number of stories*
Number of bathrooms*
Roof Type
Other Roof Type
Roof Age*
Exterior wall material (brick, siding, stucco, etc.)
Heating System*
Heating System Year Updated
Cooling System*
Cooling System Year Updated
Any galvanized, cast iron, PEX or polybutylene Pipes?
Garage type
Attached Garage Type
Basement*
Safety Features*
- Security System
- Fire Sprinkler System
- Smoke Detector
Do you own any high-value items you’d like to insure separately (jewelry, art, collectibles)?
Any recent claims in the past 5 years?*
Please describe claim*
Do you run a business from your home?*
Do you have any pets?*
How Many Pets?
First Pet's Type and Breed*
Second Pet's Type and Breed*
Third Pet's Type and Breed*
Fourth Pet's Type and Breed*
Fifth Pet's Type and Breed*
Address
Street Address*
Second Street Line (Suite, Apartment, or Building #)
City*
State*
Zip Code*
Is This Address Also The Mailing Address?*
Mailing Address (Street Address/City/State/Zip Code)*
Auto Insurance
Do You Currently Have Auto Insurance?*
Current insurance company
Policy expiration date (MM/DD/YYYY)
Desired Coverage Effective Date (MM/DD/YYYY)*
Do you have a current auto insurance declaration page?*
Please upload it here:
Drop files here or

Max. file size: 59 MB.
Coverage Limits
Liability Limits*
Other Liability Limit*
Medical Payments Coverage*
Uninsured/Underinsured Motorist Limits*
Other Uninsured/Underinsured Motorist Limits*
Number Of Vehicles*
Vehicle Information
Year/Make/Model*
Vehicle Identification Number (VIN)*
Ownership*
Primary Use*
Primary Driver*
Towing*
Extended Transportation Vehicle 1*
Extended Transportation Amount Vehicle 1*
Comprehensive Coverage?*
Comprehensive Deductible Preference*
Collision Coverage?*
Collision Deductible Preference*
Any customized equipment?*
Value of customized equipment*
Vehicle Information 2
Year/Make/Model*
Vehicle Identification Number (VIN)*
Ownership*
Primary Use*
Primary Driver*
Towing*
Extended Transportation Vehicle 2*
Extended Transportation Amount Vehicle 2*
Comprehensive Coverage?*
Comprehensive Deductible Preference*
Collision Coverage?*
Collision Deductible Preference*
Any customized equipment on second vehicle?*
Value of customized equipment*
Vehicle Information 3
Year/Make/Model*
Vehicle Identification Number (VIN)*
Ownership*
Primary Use*
Primary Driver*
Towing*
Extended Transportation Vehicle 3*
Extended Transportation Amount Vehicle 3*
Comprehensive Coverage?*
Comprehensive Deductible Preference*
Collision Coverage?*
Collision Deductible Preference*
Any customized equipment on third vehicle?*
Value of customized equipment*
Vehicle Information 4
Year/Make/Model*
Vehicle Identification Number (VIN)*
Ownership*
Primary Use*
Primary Driver*
Towing*
Extended Transportation Vehicle 4*
Extended Transportation Amount Vehicle 4*
Comprehensive Coverage?*
Comprehensive Deductible Preference*
Collision Coverage?*
Collision Deductible Preference*
Any customized equipment on fourth vehicle?*
Value of customized equipment*
Vehicle Information 5
Year/Make/Model*
Vehicle Identification Number (VIN)*
Ownership*
Primary Use*
Primary Driver*
Towing*
Extended Transportation Vehicle 5*
Extended Transportation Amount Vehicle 5*
Comprehensive Coverage?*
Comprehensive Deductible Preference*
Collision Coverage?*
Collision Deductible Preference*
Any customized equipment on fifth vehicle?*
Value of customized equipment*
Driver Information
Driver's License Number*
State of issue*
Years licensed*
Marital Status (Single / Married / Divorced / Widowed)*
Any accidents or violations in the past 5 years?*
Any additional drivers?*
How Many Additional Drivers?*
Additional Driver 1
Name*
Driver's License Number*
State of issue*
Relationship Additional Driver 1*
Other*
Additional Driver 2
Name*
Driver's License Number*
State of issue*
Relationship Additional Driver 2*
Other*
Additional Driver 3
Name*
Driver's License Number*
State of issue*
Relationship Additional Driver 3*
Other*
Additional Driver 4
Name*
Driver's License Number*
State of issue*
Relationship Additional Driver 4*
Other*
Additional Driver 5
Name*
Driver's License Number*
State of issue*
Relationship Additional Driver 5*
Other*
Life Insurance
Do you qualify for Erie Express Life? Ages of 19 to 40 qualifies (NO MEDICAL EXAM REQUIRED).
Smoker or Non-Smoker?*
Height*
Weight*
Type of Life Insurance Policy*
Term Policy Years*
Coverage Amount $250,000, $500,000 or whatever amount preferred*
Business Insurance
Do You Currently Have Business Insurance?
Current Insurance Company
Policy Expiration Date (MM/DD/YYYY)
Do you have a current business insurance declaration page?
Please upload it here:
Drop files here or

Max. file size: 59 MB.
Effective Date (MM/DD/YYYY)*
Name of Owner*
Owner Mailing Address (Street Address/City/State/Zip Code)*
Owner Cell Phone*
Owner Email*
Additional Owner's Name (if applicable)
Additional Owner's Email (if applicable)
Name of Business*
Business DBA
Business Street Address*
Business Second Address Line (Suite, Apartment, or Building #)
Business Address City*
Business Address State*
Business Address Zip*
Business Phone
Website (if applicable)
Federal Tax ID or SSN*
Business Entity (LLC, Corp, S-Corp, Sole Prop)*
Type of Business (Brief Description)*
Years in Business*
Years Experience in the field*
Gross Sales (est.)*
Annual Payroll (est.)*
Business Personal Property Coverage ($)
Number of Full Time Employees*
Number of Part-Time Employees*
Percentage of Work Subcontracted
Building Coverage*
Building Value ($)
Building Sq. Ft. (or rental space sq ft)*
Safety Features
Fire Alarm
Burglar Alarm
Sprinkler System (0-100%)
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.