Change use of Vehicle

Tools & Resources

Policy Change Forms – Change use of 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 #:

 

Vehicle Information

 

Vehicle make:

Year:

Model:

Use of vehicle:    

Comments (details if use is other):

Is this vehicle used out of the province more than 30 days/year?

 

Is this vehicle used for commercial or delivery purposes?

 

Kilometres traveled per year:    

 

How many kilometers one-way for daily commute?    

 

If this vehicle is used for work-related travel, how many kilometers/year (not including travel to and from the workplace)?

 

Effective Date

 

When will this change be effective?

 

About Your Insurance

 

(Specify the policy to which this change applies)

Company:

Policy #:

Will this change in use result in changes in use of any other vehicles owned? (If so, please indicate what will change:)

 

Name of your broker: