Refer a Friend!


For every friend or family member that you refer to our agency, we will instantly send you a $25 Visa gift card if they start a new policy with us!*

Or we can credit your next monthly payment $25.  Your choice!

So please have them call us at 800-875-8712 (make sure they mention your name) or fill out this form for them!

Let us help make insurance FAST, EASY and AFFORDABLE for your friends too!

* This offer is only available to clients of the Dan Kitajima Insurance Agency located in California.

Your Information

Your Name

Your Email

Your Friend's Information

Friend's Name

Friend's Email

Friend's Phone

Your Agent (Optional)