Home / Condo / Tenants Claims History Report


Tools

To receive your Home Insurance Claims History Report:

ยท         Print and complete the form below, then send your request by one of the options below:

  • Fax: 514-415-3989
  • Mail:
    CGI Technical Assistance
    1350 Rene-Levesque West, 7th Centre Floor
    Montreal, PQ H3G 1T4 
 
FULL NAMES OF HOME OWNERS:
 
________________________________________________________
 
 
COMPLETE MAILING ADDRESS:
 
__________________________________
 
__________________________________
 
__________________________________
 
__________________________________
 
 
 
PREVIOUS ADDRESS IF AT ABOVE ADDRESS LESS THAN FIVE YEARS:
 
____________________________________
 
____________________________________
 
____________________________________
 
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DAYTIME PHONE NUMBER:   ___________________________________
 
 
DATES OF BIRTH FOR EACH HOMEOWNER:
 
 
 
MO_____  DAY _____  YEAR _____________
 
 
MO _____ DAY _____  YEAR _____________
 
 
 
 
Please provide me with a copy of my home/tenant/condo history report.
 
Thank you for your assistance.
 
 
 
Signatures:
 
X _________________________________________________________________
 
X _________________________________________________________________
 
 
 
 
 
 
 
 
 
 
 
 
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