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If you have Insurance inquiries or other questions, please fill out the following form to contact us. Thank you.

Quotes Insurance details form Fill up

Your full name?*(Required)

Your personal mobile number?*(Required)

Personal Email Address please?*(Required)

Broker Person Name or Referral Person Name

If you need Auto Insurance? Than click Yes to fill up details*(Required)

Are you buying auto insurance 1st time in canada?

What is your date of birth?

Ontario Driving License number please in format X0000-00000-00000?*(Required)

Please give your G1 license date(do not know than give year)

Please give your G2 license date(do not know than give year)

Please give your G license date(do not know than give year)

Current Address or Address on which you want Insurance quote?

What is your current Auto insurance company?

What is your current or renewal insurance rate annual premium?

What is current auto insurance renewal date?

How much KMs you drive to work daily? May be 10kms or 15 kms or 20 kms

How much KMS per year you drive approximately may be 10,000 or 12,000 or 15,000?

Do you change tire in winter means Like do you have 8 sets of tire?

How many other drivers in home?

Do you currently rent or own home?

What is your education?

What is your current job title?

Parking car in basement or private drive way?

Are you Single or Married?

If you want to add spouse or friend or brother share same details of them as yours

Any accident or tickets?

Buying New Car or Used car , Please provide us VIN Number or otherwise leave it blank

Anything you want to mention and let us know please write comments?

Do you need tenant/rental home insurance quote ?(Required)

Always combined auto and tenant/home policy is cheaper.
Click YES to fill up details

When did you buy 1st time tenant or renters insurance please give month and year?

If live in apartment/condo how many floors in building?

What is your current floor you live in building?

Month and year you move to this address?

How many smoke detector in apartment or house?

If you own home & If you need home insurance? Than click yes to fill up details*(Required)

Details of Owner, Husband details Name , DOB , Email & Wife Details Name DOB, Email

Ignore if given

Address of home you want insurance?

When did you buy house mention date, month and year?

What is Year built of house ?

When was last Electrical update done in your home?

When was last Plumbing update done in your home?

When was last Roofing update done in your home?

When was last heating update done in your home?

When was last water heating update done in your home?

How many bedrooms you have in whole house including basement?

How many total washrooms in home?

How many smoke detector in home?

How far is fire hall from home is it 3km or 5km or 10kms?

How far is fire hydrant from home? Is it 150 meters or 300 meters or ?

Is basement finished ? If yes are you renting it to student or family?

If you need quote for Visitor Visas or Super Visas Insurance?

Father Full Name same as Passport?

Mother Full Name same as Passport?

Date of Birth as per passport Father?

Date of Birth as per passport Mother?

Email of person staying in Canada Son or Daughter or ?*(Required)

Address in Canada

Personal Mobile Number of person staying in Canada*(Required)

Any Medication going on right now everyday or every month mention details for both if any?

Date of Arrival?

Date of Departure?

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