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Motor Vehicle Liability Insurance Card

Enter the following information for the liability insurance card. * Asterisk indicates required fields. A sample of a formatted card is displayed at the bottom of this page below the form.

Vehicle Information
* Year
* Make
* Model
* Identification number (VIN)
Licence plate number
Fleet Contact Person
* Full Name
PositionEnglish
French
Organization
Branch / Sector / DirectorateEnglish
French
* Department* English
* French
Telephone
* Area Code(  ) * Number- Ext. 

Sample Card

The image below demonstrates how the information from the form above will be formatted. Note the pink background with a Canada watermark, the Governmant of Canada Federal Identity Program identifier in the upper left corner, and the Canada wordmark in the lower right corner. If non-mandatory information is omitted, the corresponding labels will also be omitted.

Sample card showing how the information submitted will be formatted.
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