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:



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)


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: