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Tenant Insurance Address Change Request
Policy Holder Name
*
Email Address
*
Phone Number
*
What date would you like the change to take place?
*
What is your new address?
*
Street Address
Address Line 2
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland & Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
If you are in an Apartment/Condo, please include your unit number.
Building Details
What is the approx year the building was built?
*
What is the main heating type in your building?
*
Select One
Electric Heat
Hot Water Baseboards
Natural Gas
Forced Air
Other
What kind of primary heat do you have?
*
Is there a wood stove or pellet stove?
*
Yes
No
How many units are in the building?
*
How many families are in your unit?
*
How many floors are in the building?
*
Do you run a home-based business? (working from a home office is not considered running a home-based business)
*
Yes
No
What kind of business do you run?
*
Are there any businesses located at the bottom of your apartment building?
*
Yes
No
What kind of businesses?
*
Coverage's
What personal liability limit would you like?
*
$1,000,000 Liability
$2,000,000 Liability
Helps to protect you financially if you accidentally cause property damage or bodily injury to others at home or anywhere in the world.
What deductible would you like to have?
*
$500 Deductible
$1,000 Deductible
This is the amount you are responsible for paying out-of-pocket before your insurance policy kicks in to cover an insured loss (up to your policy limit) in the event of a claim.
How much coverage would you like for your contents?
*
$20,000
$25,000
$30,000
Other Limit
This includes any of your property items that might be damaged from a disaster or stolen from your rental space.
What amount would you like for your contents coverage?
*
Would you like any of the following coverages?
*
Sewer Back Up - an extension to your tenant insurance policy, which will pay for damages done by, well, the sewer system backing up.
Overland Water - protects against damage caused when above groundwater enters through the foundation, basement floors or walls, or through a sewer line. It covers damage caused by freshwater floods such as the overflow of a river, lake, or other body of water.
Identity Theft - covers some of the costs related to identity theft.
Other Residents
Is there anyone on the lease other than yourself?
*
Yes
No
Name
*
First Name
Last Name
Date of Birth
*
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Relationship to You
*
Is there anyone else living at this address who is not your spouse, immediate relative or dependent?
*
Yes
No
Name
*
First Name
Last Name
Date of Birth
*
Month
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1920
Relationship to You
*
Bundle & Save - Do you need Auto Insurance at your new address? Did you know you could save up to 15% on your car insurance by bundling it with your tenant insurance? If you don’t already have car insurance with Cheep Insurance, would you like a quote?
*
No
Yes
Do you have any other comments to make for this change?
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