Add a Vehicle

Tools & Resources

Policy Change Forms – Add a Vehicle

About You:


Name(s) of insured(s):

1st insured:

2nd insured:

How can we reach you?    

E-mail address:

Daytime telephone #:

Home telephone #:

Fax #:


New Vehicle


Vehicle make:



Condition at time of purchase:    

Purchase date:

Purchase price:

VIN (vehicle ID #):

Any non-factory modifications to the vehicle?


Any unrepaired damage?

If yes, specify:

Is vehicle leased or financed?

If yes, specify:

Name of registrant:

Use of vehicle:    

Comments (details if use is other):

Kilometres traveled per year:    

How many kilometers one-way for daily commute?    


Will replacing this vehicle result in changes in use of other vehicles owned?


Third party Liability coverage requested:    


Collision coverage and deductible requested:


Comprehensive coverage and deductible requested:


All perils coverage and deductible requested:


Driver Information


(for all drivers who will be operating this vehicle)


Date of birth

Driver type:


Effective Date


When will this change be effective?


About Your Insurance


(Specify the policy to which this change applies)


Policy #:

Additional Comments:

Name of your broker: