Identify the subject of the request

Use this form to identify the subject of the personal information request.

Enter your identification and contact information below.

Important Notice:The Farmers Insurance Group® has acquired the MetLife Auto & Home business from MetLife, Inc. Therefore, the MetLife companies are no longer affiliated with MetLife Auto & Home and are no longer responsible for any of MetLife Auto & Homes’ activities. The Farmers Insurance Group will be responsible for your policy and its administration going forward. To learn more and submit a personal information request, please visit https://www.farmers.com/california-consumer-privacy/.

All fields are required unless noted

First Name

Please ensure that names are entered as they appear on your policy

Last Name

Please ensure that names are entered as they appear on your policy

Address

Street Number

Street Name

Apt/Suite # (optional)

City

State

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Zip Code

Email Address

This email address is available.

Confirm Email

Primary State or Territory of Residence

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Date of Birth

Social Security number

Confirm Social Security number

How would you like to receive your verification code?

Text Message (Personal Mobile Number) Voice Message (Personal Mobile Number/Home Number)

Please select any option.

Text Message Consent

I acknowledge that by choosing the text message option, I may incur charges to my mobile plan.

I acknowledge that by choosing the text message option, I may incur charges to my mobile plan.

Personal Mobile Number/Home Number

* Please ensure that the phone number is associated with the personal information entered above.

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