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Musical Instrument Insurance : Step 1 - Change Request Form
Main
What Does it Cover?
Get a Quote for Your Musical Instrument
Register Online Now!
How to Make a Claim
Change Your Policy or Personal Information
Certificate Number:*
Personal Information
Name of Policy Holder:*
Address:*
City:*
Province:*
Postal Code:*
Telephone:*
Fax:
Email:
Personal Information Change
Only fill in the information that you want changed.
Name of Policy Holder:
Address:
City:
Province:
Postal Code:
Telephone:
Fax:
Email:
Changes to Your Policy
Check off all that apply
Add an Instrument
   How many instruments do you want to add?
Change the value of an Instrument
   How many instruments will have their value changed?
Delete an Instrument
   How many instruments do you want to delete?