- AUTO INSURANCE - Auto Insurance Quote Form Fill out the following form as completely as possible. Once you have completed the form, click Submit to send your information to Insurance Discounters of Ohio. We will handle your request shortly. Please enable JavaScript in your browser to complete this form.Full Name *FirstLastVehicle Used *Relationship *SpouseSelfChildParentGender *MaleFemaleDate of Birth *Percent UseDriver License NumberState IssuedOhioKentuckyIndianaTexasSR22 RequiredYesNoNext