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1100 Burloak Dr, Suite 300, Burlington, ON
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All You Need
Commercial Insurance
Automobile Insurance
Home Insurance
Group Insurance Plans
Life and Health Insurance
HIFA Believers
Helpful FAQs
Let’s Talk
Existing Clients
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Your Team
All You Need
Commercial Insurance
Automobile Insurance
Home Insurance
Group Insurance Plans
Life and Health Insurance
HIFA Believers
Helpful FAQs
Let’s Talk
Existing Clients
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Add a Driver
Date
Policy holder information
Full name
Phone
Email
Policy#
Please add the following driver to my policy
Effective date:
Full name:
Date of birth:
Address
Street address
Unit#, etc.
City
Province
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ON
QC
NS
NB
MB
BC
PE
SK
AB
NL
Postal code
Date received G1:
Date received G2:
Date received G:
Completed MTO driver's training?
Yes
No
MTO driver's training certificate#
Are you a student?
Yes
No
Residing at home or at campus
Home
Campus
If student living at campus, proof must be provided:
Relationship to the insured
Date first insured in canada
Date started insurance with current co.
# of minor convictions/tickets in last 3 years
# of major convictions in last 6 years
# of accidents at fault in last 8 years
# of accidents not at fault in last 8 years
# of claims in last 6 years
Pay out for claim (use + sign to enter the amount for each claim)
Amount
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