Fast-Track Auto Questionnaire

1Applicants

2Vehicles

3Additional Info

4Required Documents

Congratulations! Based on the information you submitted, our insurance products appear to be a good fit for you.
Bundled Auto Insurance Quote

Estimated time to complete: 5 minutes

How everything works:
1) You fill out this form.
2) A local broker will carefully work on your quote, and get in touch with you for additional information if needed.
3) Review coverage options with your broker by phone or appointment, and start your policy!
Fast-Track Auto Questionnaire

Estimated time to complete: 10 minutes

How everything works:
This form gathers the details needed for your auto insurance application, including questions about your vehicle and drivers, and a list of required documents. By completing this form, you confirm that the information is true to the best of your knowledge. This helps your broker fast-track your insurance application.

You may save and continue this form at any time.
Who is the broker working on this quote?*
How many applicants are there?*
The applicants are the individuals with signing authority on the insurance policy as well as ownership of vehicle(s), and are financially responsible for the insurance policy. There may be a single applicant for an insurance policy containing multiple drivers and vehicle.
Applicant Info
Name of Applicant 1*
First Last
Occupation and Place of Employment for Applicant 1
Some occupations or employers may be eligible for additional discounts.
Email Address for Applicant 1*

This email will be used to electronically sign your application later.
Name of Applicant 2*
First Last
Occupation and Place of Employment for Applicant 2
Some occupations or employers may be eligible for additional discounts.
Email Address for Applicant 2*

This email will be used to electronically sign your application later.
Name of Applicant 3*
First Last
Occupation and Place of Employment for Applicant 3
Some occupations or employers may be eligible for additional discounts.
Email Address for Applicant 3*

This email will be used to electronically sign your application later.
Name of Applicant 4*
First Last
Occupation and Place of Employment for Applicant 4
Some occupations or employers may be eligible for additional discounts.
Email Address for Applicant 4*

This email will be used to electronically sign your application later.
Does any applicant for insurance currently owe any money on another Alberta Automobile Policy?*
Example: monthly payment NSF'ed, leading to cancellation of auto insurance and outstanding balance.

How many vehicles are there on the application?*
Vehicle 1
Upload Bill of Sale or Registration for Vehicle 1
Accepted file types: jpg, jpeg, gif, png, pdf, tif, Max. file size: 10 MB.
If you have a scanned copy of one of the following, you may upload it here:

1) Bill of sale
2) Vehicle Registration

Alternately, you can take a picture with your cellphone and email directly to the broker (please send on medium quality to keep file sizes low).

Allowed file extensions: .jpg, .jpeg, .gif, .png, .pdf, .tif
Max size: 10MB
Please confirm the VIN for Vehicle 1
You may skip this step if you have already uploaded the Bill of Sale or Registration for the vehicle.
Is Vehicle 1 financed or leased?*
Name of Financing/Leasing Company*
Address of Financing/Leasing Company*
Vehicle 2
Upload Bill of Sale or Registration for Vehicle 2
Accepted file types: jpg, jpeg, gif, png, pdf, tif, Max. file size: 10 MB.
If you have a scanned copy of one of the following, you may upload it here: 1) Bill of sale 2) Vehicle Registration Alternately, you can take a picture with your cellphone and email directly to the broker (please send on medium quality to keep file sizes low). Allowed file extensions: .jpg, .jpeg, .gif, .png, .pdf, .tif Max size: 10MB
Please confirm the VIN for Vehicle 2
You may skip this step if you have already uploaded the Bill of Sale or Registration for the vehicle.
Is Vehicle 2 financed or leased?*
Name of Financing/Leasing Company*
Address of Financing/Leasing Company*
Vehicle 3
Upload Bill of Sale or Registration for Vehicle 3
Accepted file types: jpg, jpeg, gif, png, pdf, tif, Max. file size: 10 MB.
If you have a scanned copy of one of the following, you may upload it here: 1) Bill of sale 2) Vehicle Registration Alternately, you can take a picture with your cellphone and email directly to the broker (please send on medium quality to keep file sizes low). Allowed file extensions: .jpg, .jpeg, .gif, .png, .pdf, .tif Max size: 10MB
Please confirm the VIN for Vehicle 3
You may skip this step if you have already uploaded the Bill of Sale or Registration for the vehicle.
Is Vehicle 3 financed or leased?*
Name of Financing/Leasing Company*
Address of Financing/Leasing Company*
Vehicle 4
Upload Bill of Sale or Registration for Vehicle 4
Accepted file types: jpg, jpeg, gif, png, pdf, tif, Max. file size: 10 MB.
If you have a scanned copy of one of the following, you may upload it here: 1) Bill of sale 2) Vehicle Registration Alternately, you can take a picture with your cellphone and email directly to the broker (please send on medium quality to keep file sizes low). Allowed file extensions: .jpg, .jpeg, .gif, .png, .pdf, .tif Max size: 10MB
Please confirm the VIN for Vehicle 4
You may skip this step if you have already uploaded the Bill of Sale or Registration for the vehicle.
Is Vehicle 4 financed or leased?*
Name of Financing/Leasing Company*
Address of Financing/Leasing Company*
Vehicle 5
Upload Bill of Sale or Registration for Vehicle 5
Accepted file types: jpg, jpeg, gif, png, pdf, tif, Max. file size: 10 MB.
If you have a scanned copy of one of the following, you may upload it here: 1) Bill of sale 2) Vehicle Registration Alternately, you can take a picture with your cellphone and email directly to the broker (please send on medium quality to keep file sizes low). Allowed file extensions: .jpg, .jpeg, .gif, .png, .pdf, .tif Max size: 10MB
Please confirm the VIN for Vehicle 5
You may skip this step if you have already uploaded the Bill of Sale or Registration for the vehicle.
Is Vehicle 5 financed or leased?*
Name of Financing/Leasing Company*
Address of Financing/Leasing Company*
Vehicle 6
Upload Bill of Sale or Registration for Vehicle 6
Accepted file types: jpg, jpeg, gif, png, pdf, tif, Max. file size: 10 MB.
If you have a scanned copy of one of the following, you may upload it here: 1) Bill of sale 2) Vehicle Registration Alternately, you can take a picture with your cellphone and email directly to the broker (please send on medium quality to keep file sizes low). Allowed file extensions: .jpg, .jpeg, .gif, .png, .pdf, .tif Max size: 10MB
Please confirm the VIN for Vehicle 6
You may skip this step if you have already uploaded the Bill of Sale or Registration for the vehicle.
Is Vehicle 6 financed or leased?*
Name of Financing/Leasing Company*
Address of Financing/Leasing Company*
Vehicle 7
Upload Bill of Sale or Registration for Vehicle 7
Accepted file types: jpg, jpeg, gif, png, pdf, tif, Max. file size: 10 MB.
If you have a scanned copy of one of the following, you may upload it here: 1) Bill of sale 2) Vehicle Registration Alternately, you can take a picture with your cellphone and email directly to the broker (please send on medium quality to keep file sizes low). Allowed file extensions: .jpg, .jpeg, .gif, .png, .pdf, .tif Max size: 10MB
Please confirm the VIN for Vehicle 7
You may skip this step if you have already uploaded the Bill of Sale or Registration for the vehicle.
Is Vehicle 7 financed or leased?*
Name of Financing/Leasing Company*
Address of Financing/Leasing Company*
Vehicle 8
Upload Bill of Sale or Registration for Vehicle 8
Accepted file types: jpg, jpeg, gif, png, pdf, tif, Max. file size: 10 MB.
If you have a scanned copy of one of the following, you may upload it here: 1) Bill of sale 2) Vehicle Registration Alternately, you can take a picture with your cellphone and email directly to the broker (please send on medium quality to keep file sizes low). Allowed file extensions: .jpg, .jpeg, .gif, .png, .pdf, .tif Max size: 10MB
Please confirm the VIN for Vehicle 8
You may skip this step if you have already uploaded the Bill of Sale or Registration for the vehicle.
Is Vehicle 8 financed or leased?*
Name of Financing/Leasing Company*
Address of Financing/Leasing Company*

Additional Info
Is there any unrepaired damage to any vehicle?*
Please provide details on the extent of damages, and email a picture of the damage to your broker.*
Are any vehicles currently under a salvage title?*
Are any vehicles used outside of Canada on a regular basis?*
Please provide details on usage outside of Canada*
Are there any aftermarket modifications or customizations to any vehicles?*
E.g. engine, ground clearance, interior roll cage, tire modifications, etc.
Please provide full list of aftermarket modifications.*
Note: most automobile policies limit or restrict coverage for aftermarket modifications. Undisclosed modifications may also void your policy. Carefully review your policy, and discuss any aftermarket modifications with your insurance company.
Are any vehicles rented or leased to others (e.g. Turo), or used for carrying goods or passengers for compensation or hire (e.g. Uber, courier, delivery)?*
Please provide details for each vehicle:*
Are any vehicles used for any business or commercial use?*
Please provide details for each vehicle:*
Are any vehicles used to carry explosives or radioactive material?*
Please provide details for each vehicle:*
What is your preferred payment method for this application?*
Note: monthly payment plans are subject to eligibility requirements.
Upload a copy of your Direct Deposit or Void Cheque form.
Accepted file types: jpg, jpeg, gif, png, pdf, tif, Max. file size: 10 MB.
If you have a scanned copy of your Direct Deposit Form or Void Cheque you can upload it here. Alternately, you can take a picture with your cellphone and email directly to the broker (please send on medium quality to keep file sizes low). Allowed file extensions: .jpg, .jpeg, .gif, .png, .pdf, .tif Max size: 10MB
Preferred Monthly Withdrawal Date*
Select a day between 1 - 27
Do you prefer Paper or Paperless copies of your documents
Note: Paper may not be available for all carriers.

Bundled Auto Insurance Quote

Applicant Info

Vehicle 1

Vehicle 2

Vehicle 3

Vehicle 4

Vehicle 5

Vehicle 6

Vehicle 7

Vehicle 8

Additional Info

Required Documents