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Keeping your single most important investment safe means trusting people that care for your wellbeing. At Great Lakes Mutual, we’ve been insuring our policy-holders homes and honoring their trust for over a century.

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Flexible insurance. It’s what you expect and what Great
Lakes Mutual offers – because no two pieces of property are the same. Contact a GLM agent today to get started on your tailored market value policy.

Learn More

Flexible insurance. It’s what you expect and what Great
Lakes Mutual offers – because no two pieces of property are the same. Contact a GLM agent today to get started on your tailored market value policy.

Learn More

Protecting your personal property shouldn’t cost a small
fortune. Whether you rent a home, duplex or apartment,
affordable contents insurance is right around the corner.

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Great Lakes Mutual

 

 

All form fields must be completed except where noted. Incomplete form fields will not allow the form to be submitted to Great Lakes Mutual Insurance.

Recurring Payment Authorization

Here's How Recurring Payments Work:

You authorize regularly scheduled charges to your checking/savings account or credit card according to the payment plan you have selected. A $5.00 installment fee will be applied to semi-annual or quarterly payments. A receipt for each payment will be emailed to you. You agree that no prior-notification will be provided unless the date or amount changes, in which case you will receive notice from us at least 10 days prior to the payment being collected.

Payment Frequency Option:

 

Please choose payment option:

 

Annual

Semi-Annual

Quarterly

Monthly - (no installment fee)

Insured/Policy Information:  

 

Policy Number(s):

 
   

First Name:

Last Name:

Phone Number:

Email Address:

 

Payment Type:

 

   

Billing Address:

Billing Address Line 2 (optional):

Billing City:

Billing State:

   

Billing Zip Code:

 
 
 
 

Authorization:

 

BY CHECKING THIS BOX, I AUTHORIZE THE CHARGE ON MY ACCOUNT ACCORDING TO THE TERMS INDICATED IN THIS ACH AUTHORIZATION AGREEMENT. I AGREE TO NOTIFY IN WRITING OF ANY CHANGES TO MY ACCOUNT INFORMATION OR TERMINATION OF THIS AUTHORIZATION AT LEAST 15 DAYS PRIOR TO THE NEXT BILLING DATE. I UNDERSTAND THAT THIS AUTHORIZATION WILL REMAIN IN EFFECT UNTIL I CANCEL IT IN WRITING. I CERTIFY THAT I AM AN AUTHORIZED USER OF THIS ACCOUNT AND WILL NOT DISPUTE TRANSACTIONS WITH MY BANK; SO LONG AS THE TRANSACTIONS CORRESPOND TO THE TERMS INDICATED HEREIN.

 

 

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