Auto Insurance Good Student Discount Application - USAA
GOOD STUDENT DISCOUNT
(GSD)
9800 Fredericksburg Road
San Antonio, Texas 78288
SAVINGS TO YOU!
This form has been sent to you because of your request or because our records show that you have one or
more young drivers on your Automobile policy who may be eligible for a good student discount. To qualify
this person must be licensed to drive, meet at least one of the scholastic requirements given on the
application and be currently a:
1. Full time student in a high school, college, university or vocational technical school;
2. At least 16 years old and under the age of 25.
IF YOU HAVE RECEIVED THIS DISCOUNT IN THE PAST¡
Now is the time to re-apply. This discount is not automatically renewed. Recertification is required
annually.
TO RECEIVE THIS DISCOUNT NOW¡
We need your electronic signature (e-signature) or a signed application or other proof, as outlined below,
for each operator qualifying for GSD.
On ¡
We will require your e-signature certifying each operator qualifies for GSD:
? In Georgia or Guam, if you issue an auto policy or update operator information;
? In Puerto Rico, if you update operator information.
If you prefer to make this change online, go to Update Discounts on your Auto policy.
Mail or fax¡
?
?
Fill out the attached application and sign it to indicate that the student has met at least one of the
requirements listed on the application for the school semester immediately preceding the effective
date: a policy is issued; renewed; or an operator is first added to an existing policy.
Instead of an application completed by you or your e-signature, we¡¯ll accept:
?
A transcript*; or
?
Other proof of academic performance, such as a grade report, letter from the dean or similar
scholastic achievement list*; or
?
The application completed by a school official.
*If you send a transcript, grade report, letter from the dean or similar scholastic achievement list,
please write the number ¡°485¡± at the top of the page.
Additional applications¡
Are available upon request or you may copy the attached application or print one from . The
Good Student Discount Application is under:
My Account Tools¡úDocuments and Forms¡úGet Forms.
REMEMBER¡
?
?
If you choose to mail us the application, please return the completed Application for Good
Student Discount on the next page right away--within 30 days.
A new GSD application is required annually.
USAA ? 1-800-531-USAA (8722) ? Fax 1-800-531-8877 ?
485GGPWC (12-13)
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APPLICATION FOR GOOD STUDENT DISCOUNT
We must have this signed application or other verification before allowing the Good Student Discount
credit. Instead of this form, you may send us a report card, transcript or copy of the Dean¡¯s letter.
NOTE: If you send a transcript, grade report, letter from the dean or similar scholastic achievement
list, please write the number ¡°485¡± at the top of the page.
In consideration of the premium discount to be applied to the automobile policy, I certify for the semester
ending immediately preceding the date shown below each child listed:
1. Is currently enrolled as a full-time student in a high school, college, university or vocational technical
school.
2. Attained one or more of the scholastic goals indicated:
? Ranked in upper 20% of the class scholastically;
? If letter grades used, had grade average of B or higher; (if the letter grades cannot be averaged
then no grade can be below B);
? If number grades used, had at least 3 point average on a 4 point scale (or equivalent); or
? Was included on the "Honor Roll" or "Dean's List" or similar scholastic achievement list.
Upon receipt of this completed and signed document, we will update your policy information.
USAA Number:
I understand the Good Student Discount must be reapplied for annually.
Student's Full Name
Name of School
1.
2.
3.
4.
5.
6.
7.
Signature of Policyholder, Spouse, Parent or School Official
Date
Please print your name
I understand that a misrepresentation in this application may constitute grounds for
termination of my insurance.
IMAGE=485
485GGPWC (12-13)
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