CHANGE THE DATE OF MY PREAUTHORIZED PAYMENTS

Auto and home insurance

Use this form to submit your request securely.

IMPORTANT

Use this form to change to your direct debit dates.

Changes will not be made to scheduled withdrawals for the next five business days.

If your request concerns a scheduled withdrawal in the next five business days, please contact us at 1-877-700-7778.

Insurance policyholder

First name

Last name

Email address

Date of birth

mm-dd-yyyy

Pour quelle assurance désirez-vous modifier your payment schedule?

My auto policy

Policy number Contains between 8 and 11 characters

My home insurance

Policy number Contains between 8 and 11 characters

My leisure vehicle and RV insurance

Policy number Contains between 8 and 11 characters

Withdrawal(s) affected

Do you want to change the date of one or all future withdrawals?

Date of withdrawal to be changed

mm-dd-yyyy

New withdrawal date

mm-dd-yyyy

The date on which future payments will be made

Date you would like the change to take effect

mm-dd-yyyy

Information regarding the request (optional)

Maximum of 5,000 characters

Character count:

The personal information collected by iA Financial Group and its affiliates regarding your claim will only be used and shared to the ends to which you have already consented.

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I confirm that I am the owner of the above-mentioned policy(ies) and am authorized to make this request.

I understand that the requested change(s) will take effect when I receive confirmation by email or by telephone.