Coverage |
Premiums
| Application | Privacy
Consent | Required
Documents
Application Form
For Modified, Street Rod & Custom Automobile Insurance™
To apply for insurance coverage please take a few moments to complete
the following forms. Please note the requirements below.
Requirements:
- Current Drivers Abstract for all operators
- Copy of a pink card insuring your daily driver vehicle
- Completed Custom Wheel Application Form
- Completed Privacy Consent Form
- Proof of Vehicle Ownership (bill of sale or registration)
- Payment in the form of a cheque or money order payable to
Elite Insurance Company.
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