To Change your VEHICLE use and distance to work, email to Broker

We will forward it to your Personal Broker

 
  First Name  
  Last Name  
Postal Code
       
  Email
Policy Number
  Insurance Company
  Effective Date of your Requested Change
  Did you stop using your car to commute to work?
    Yes, I stopped using my car to commute to work.
    No, I still use my car to commute to work.
    No, I wasn't using my car to commute to work in the first place.
  Have your driving habits changed (ex: using your car for essential travel only)?
    Yes, my driving habits have changed and and the kilometres I drive have decreased.
    No, my driving habits have not changed.
    I confirm that the information above is true, complete and accurate.
  Your Comments  
For Your Records, Before Submitting The Form

WARNING: DISTRACTED DRIVING IS NOW CONSIDERED A MAJOR OFFENCE (6 POINTS!!)AND CAN LEAD TO LICENSE SUSPENSION, HIGHER RATES AND CANCELLATION OF YOUR POLICY!!!

We appreciate your referrals! Keep us in mind if any of your friends or associates would like to save money on their insurance, and better their coverage!

WE CANNOT BIND OR HOLD ANY COVERAGE FROM EMAILS....DO NOT ASSUME YOU HAVE COVERAGE UNLESS YOU HAVE A BINDER OR LETTER BACK FROM OUR OFFICE CONFIRMING COVERAGE HAS BEEN ISSUED WITH THE INSURANCE COMPANY. Visit jdsmithinsurance.com for our Code of Conduct and Privacy Policy
WARNING: From time to time, our spam scanners eliminate legitimate email from clients. If your email contains Important instructions, please ensure that we acknowledge receipt of those instructions. Please note: The information transmitted herein is intended only for the addressee and may contain confidential, proprietary and/or privileged material. Any unauthorized review, distribution or other use of or the taking of any action in reliance upon this information is prohibited. If you receive this e-mail in error, please contact the sender and delete or destroy this message and all copies. The integrity and security of Internet communications and, in particular this email and any attachments, cannot be guaranteed. JD Smith & Associates Insurance Brokers Inc. accepts no liability whatsoever in connection therewith. You are strongly advised to carry out all necessary virus checks and that you open this email and any attachments at your own risk

To Follow Up
905-764-7868     1-800-917-SAVE     fax: 905-764-9618
JD Smith & Assoc. Insurance Brokers Inc.
JD Smith Insurance.com
email