Delete A Car Form
  1. If you need to delete a car from your policy, please complete the form below.

  2. First Name
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  3. Last Name
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  4. Address
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  5. City
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  6. Province
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  7. Postal Code
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  8. How would you like us to contact you?
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  9. Daytime Phone
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  10. Night-time Phone
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  11. Best Time To Call
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  12. Email Address
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  13. Number of vehicles you want to delete
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  14. Which vehicle do you want to delete?
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  15. VIN
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  16. Date to drop Vehicle
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  17. Who was the driver?
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  18. Which car will they be driving now?
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  19. How far will they drive to work?
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  20. Please give any additional comments you feel appropriate. If you have additional information
    where there was not enough fields above, such as additional drivers, vehicles, driver histories, etc..., please enter them here.
  21. Add comments
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  22. First Name
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  23. Last Name
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  24. Current Email Address
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  25. Submit This Form
      
 

DeHart & Stauffer Insurance Brokers Copyright © 2014. All rights reserved.
843 King Street WestOshawa, Ontario L1J 2L4 (905) 576-2234Fax 1-253-550-4655