Auto Remarket 2025 - Tanner Insurance Brokers

Before we get started please select your broker
This will better help us serve you.
Who is your broker?
If you are unsure of who your broker is, select the person who sent you this form.

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
How many vehicles would you like quoted?*
Only automobiles, we have a separate form for motorcycles, ATV’s, snowmobiles.
Make and Model of Vehicle*
Who's the Primary Driver for this Car?*
First Last
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*
The distance you drive specifically for self-employment or incoming-earning activities.
Type of Business*
Winter tires?*
What type of tire do you use in the winter?
Is the vehicle financed, leased or owned outright?*
Is The Vehicle Modified/Customized?*
Please Specify Modifications:*

Vehicle #2 Details
Make and Model of Vehicle*
Who's the Primary Driver for this Car?*
First Last
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*
The distance you drive specifically for self-employment or incoming-earning activities.
Type of Business*
Winter tires?*
What type of tire do you use in the winter?
Is the vehicle financed, leased or owned outright?*
Is The Vehicle Modified/Customized?*
Please Specify Modifications:*

Vehicle #3 Details
Make and Model of Vehicle*
Who's the Primary Driver for this Car?*
First Last
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*
The distance you drive specifically for self-employment or incoming-earning activities.
Type of Business*
Winter tires?*
What type of tire do you use in the winter?
Is the vehicle financed, leased or owned outright?*
Is The Vehicle Modified/Customized?*
Please Specify Modifications:*
Vehicle #4 Details
Make and Model of Vehicle*
Who's the Primary Driver for this Car?*
First Last
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*
The distance you drive specifically for self-employment or incoming-earning activities.
Type of Business*
Winter tires?*
What type of tire do you use in the winter?
Is the vehicle financed, leased or owned outright?*
Is The Vehicle Modified/Customized?*
Please Specify Modifications:*

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
Accident Benefit Changes in Ontario*
As of July 1, 2026, Ontario is introducing changes under the Insurance Act (Ontario) that will provide Ontario drivers with more choice and control over their Statutory Accident Benefits coverage. Under the new rules, only medical, rehabilitation, and attendant care benefits will remain mandatory, while many other important coverages such as, income replacement, caregiver benefits, and death and funeral benefits will become optional and must be selected by the policyholder.
We encourage you to review the resources provided upon completion of this form.
I acknowledge that I’ve read the Accident Benefits Changes in Ontario.
Comments
Include any additional comments.

Before we get started please select your broker