Auto Remarket 2025 - Tanner Insurance Brokers

Registered Vehicle Owner
This will be the policy owner and must be the registered owner of the vehicle to be insured.
Registered Vehicle Owner's Name*
First Name Last Name
Phone Number*
Email*
Postal Code*

Vehicle #1 Details
Make and Model of Vehicle*
How many vehicles would you like quoted?*
Only automobiles, we have a separate form for motorcycles, ATV’s, snowmobiles.
Annual KM's Driven*
How many KM’s do you expect to put on the vehicle over the course of the next year?
Daily Commute KM's Driven*
Distance one-way from home to work.
Annual Business KM's Driven*
Winter tires?*
What type of tire do you use in the winter?
Is the vehicle financed, leased or owned outright?*

Vehicle #2 Details
Make and Model of Vehicle*
Annual KM's Driven*
How many KM’s do you expect to put on the vehicle over the course of the next year?
Daily Commute KM's Driven*
Distance one-way from home to work.
Annual Business KM's Driven*
Winter tires?*
What type of tire do you use in the winter?
Is the vehicle financed, leased or owned outright?*

Vehicle #3 Details
Make and Model of Vehicle*
Annual KM's Driven*
How many KM’s do you expect to put on the vehicle over the course of the next year?
Daily Commute KM's Driven*
Distance one-way from home to work.
Annual Business KM's Driven*
Winter tires?*
What type of tire do you use in the winter?
Is the vehicle financed, leased or owned outright?*
Is the vehicle financed, leased or owned outright?*
Vehicle #4 Details
Make and Model of Vehicle*
Annual KM's Driven*
How many KM’s do you expect to put on the vehicle over the course of the next year?
Daily Commute KM's Driven*
Distance one-way from home to work.
Annual Business KM's Driven*
Winter tires?*
What type of tire do you use in the winter?

Additional Details
Consent*
By providing your driver’s license number, you are hereby authorizing us to retrieve your prior insurance information, including those of any previously listed drivers from whom I have obtained consent, in order to provide you with a faster, more accurate quote. Do I have permission to retrieve your insurance information?
I agree to grant permission to retrieve my insurance information
Comments
Include any additional comments.

Registered Vehicle Owner