Add/Remove Leinholder or Lessor

Please call us if you need immediate service

Policy Holders Name:
Address:
Address 2:
City/Town:
Postal Code:
Email Address:
Home Phone:
Work Phone:
Fax Number:
Which A.P. Reid Office normally provides your policy service?:	Please select.. Amherst Bridgewater Chester Cole Harbour George Mitchell Insurance Halifax Kentville Mahone Bay Petitcodiac Porters Lake Stellarton Woodlawn Head Office - Corporate Services
Policy #:
What action are you performing on the loss payee?:	Please select.. Add Remove
Year/Make of the vehicle:
Loss Payee - Name:
Loss Payee - Address:
Loss Payee - City/Town:
Loss Payee - Province:
Loss Payee - Postal Code:
Loan Number:
Effective date of change (mm-dd-yyyy):

Please note, this transaction is not effective until you receive a confirming call, email or the Policy Declarations page showing the change. This transaction is not effective until we receive a 'release of interest' form from the payee being removed. We confirm when this change is made.