Auto Intake & CMSMTF Export

Complete the steps below. Add extra drivers or vehicles as needed. Liability/PIP is asked once and copied to all vehicles.

Autosave to Drive (optional)

If you use Google Apps Script, paste your Web App URL to receive a JSON copy on submit.

1) Customer & Policy Basics

First Name

Last Name

Email

Phone

Street

Address 2

City

State

ZIP

Currently Insured With Select

Reason for No Current Auto Insurance

Expiration Date

Years with Company

Premium Amount ($)

Pay Plan MonthlyQuarterly Semi-AnnualAnnual

Paid in Full? NoYes

How did you hear about us?

Other Agencies Quoting?

Quote Home/Renters for MPD?

Current Home/Renters Carrier Select

Reason for No Current Home/Renters Insurance

Groups / Associations Select

2) Drivers

+ Add Driver

Driver data maps to drv_* arrays like drv_sFirstName[0], drv_tBirthDate[0], etc. [oai_citation:5‡Sample PersonalAuto 1 (1).pdf](sediment://file_00000000277071f59f302a6591d6b24f)

3) Vehicles

+ Add Vehicle

Vehicle data maps to veh_* arrays like veh_sYr[0], veh_sVIN[0], coverage selections, lienholder, etc. [oai_citation:6‡Sample PersonalAuto 1 (1).pdf](sediment://file_00000000277071f59f302a6591d6b24f)

4) Rec Vehicles / Trailers / Watercraft

Add recreational items

+ Add Rec/Watercraft/Trailer

Captures Year/Make/Model, ID/HIN/VIN, length/HP/CC, usage, value, settlement, lienholder, etc. [oai_citation:7‡Auto Intake Questions.pdf](sediment://file_00000000251071f58c8e0176407623a6)

5) Coverages (applies to all vehicles)

Health insurance for auto injuries? Select Private (BCBS/Priority/United) Medicare (65+) Medicaid (income-based) None

PIP Medical (MI) Select Unlimited $500,000 $250,000 (exclude individuals) $250,000 (no exclusion) $50,000 (Medicaid only) Medicare Opt Out

If not Unlimited, Excess Attendant Care? Select YesNo

BI / Bodily Injury Select 50/100 100/300 250/500 500/500 500/1,000 1,000/1,000

Choosing BI auto-fills PD, UM, and UIM occurrence parts.

PD (auto-filled)

UM BI (auto-filled)

UIM BI (auto-filled)

Mini-Tort Limit Select $3,000

These map to gen_sBi, gen_sPd, gen_sUmBi, gen_sUimBi at policy level. [oai_citation:8‡Sample PersonalAuto 1 (1).pdf](sediment://file_00000000277071f59f302a6591d6b24f)

6) Cross-Sell & Notes

Umbrella interest? YesNo

Life Insurance carrier? Need coverage for loan/mortgage?

General Notes

Download .CMSMTF Print / Save PDF Submit + (Optional) Save

Drag-and-drop the downloaded .CMSMTF into HawkSoft to import. (Matches the arrayed naming pattern shown in your sample.) [oai_citation:9‡Sample PersonalAuto 1 (1).pdf](sediment://file_00000000277071f59f302a6591d6b24f)