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Policy Change Forms
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- Change Vehicle Use
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Policy Change Forms - Change Use of a Vehicle
About You  
Name(s) of insured(s):  
1st insured:
2st 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?
Yes     No
Is this vehicle used for commercial or delivery
purposes?
Yes     No
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? (dd/mm/yyyy)
   
About Your Insurance
(Specify the policy to which this change applies)
 
Company:
Policy #:
Additional Comments:
   
 

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