Change Address Form

You may use this convenient online form to change your policy address information. All fields marked with an asterisk (*) are required fields.

Click here to change your address with the Registry of Motor Vehicles.

Personal Details

* First Name:
* Last Name:
Date of Birth:	(mm/dd/yyyy)
Street:
City:
State:
Zip:
Day Phone:
Evening Phone:
Email:
The best way to reach me is:

"New" Personal Details

* First Name:
* Last Name:
Date of Birth:	(mm/dd/yyyy)
Street:
City:
State:
Zip:
Day Phone:
Evening Phone:
Email:
The best way to reach me is:

Additional Info

Additional Comments or Questions:

Johnson and Rohan Insurance
50 Salem Street ~ P.O. Box 52 ~ Lynnfield, Massachusetts 01940
Phone: 1-800-491-1414 or 1-781-224-0909 ~ Fax: 1-781-224-0546
E-Mail: info@JohnsonandRohan.com