InsureLine Brokers (Bethel)

INSURELINE BROKERS INC. (“INSURELINE”) IS A FULL-SERVICE INSURANCE BROKERAGE. WE SHOP THE MARKET FOR THE BEST HOME INSURANCE POLICY AMONGST CANADA’S LARGEST INSURERS TO QUICKLY GET YOU GREAT COVERAGE AT THE BEST RATE!

Many mortgages require proof of insurance as a condition of closing, which means you need to have adequate insurance coverage in place well in advance of the closing date of the purchase of your new home. Your mortgage broker works closely with InsureLine who is an insurance brokerage licensed by the provincial insurance council.
Your Information
Your Name (Applicant)*
First Last
Your Phone Number*
Your Email*
Your Occupation*
- Is there a Co-Applicant?
Co-applicant's Name*
First Last
Property Closing Date*
MM slash DD slash YYYY
Purpose*
Property Type*
Purchase Price*
Year Bult
Property Address
Street Number*
Street Name*
Street Type*
Street Direction
Unit Number
City*
Province*
Postal Code*
- Is your subject property also your mailing address?
Mailing Address
Street Number
Street Name*
Street Type*
Street Direction
Unit Number
City*
Province*
Postal Code*
Lawyer Information
Company
Contact Name
Phone Number
Referrer's Information
Referrer's Name*
Referrer's Company*
Referrer's Email*
Your Comments
CONSENT TO DISCLOSE PERSONAL INFORMATION TO A THIRD PARTY & DISCLOSURE NOTICE OF RECEIPT OF A REFERRAL FEE
As part of the mortgage application process, your mortgage broker has collected your personal information pursuant to the terms and conditions set out in their mortgage application for the purpose of obtaining financing options for you (“Personal Information”). You have requested that your mortgage broker share your Personal Information with InsureLine to provide you with home insurance quotes and information about insurance products, insurance offerings and related services. InsureLine will be paying the mortgage broker a referral fee for having referred you to InsureLine and arranging to provide your Personal Information. Your consent to share your Personal Information with InsureLine is not a pre-condition or requirement of your mortgage application. By your consent, I/we [Applicant] & [Co-Applicant] hereby confirm that I/we have read and understand the items set out above and we hereby grant consent for the mortgage broker to disclose my/our Personal Information to InsureLine for the purpose outlined above. I/We understand and agree that this is not an application form, an application for insurance or a solicitation for insurance.
CONSENT TO OBTAIN CREDIT INFORMATION
In order to provide you with the best possible price on your home insurance policy for the purpose of your quote, your insurer will obtain and use your credit information with your consent. If you provide consent for the collection and use of your credit information by InsureLine’s insurance partners, this will be a soft inquiry on your credit file and will not affect your credit score. Your email, name, date of birth, address and phone number may be shared with TransUnion or another third-party credit reporting agency to obtain your credit information. You may withdraw your consent for the use of credit at any time by contacting InsureLine at [email protected] or your insurance company.
I consent to sharing my personal information to obtain home insurance quotes.*
- Yes
I consent to a credit check so that I may obtain the best possible insurance rates.
- Yes
Applicant's Signature*
Co-Applicant's Signature*

Referral Consent

INSURELINE BROKERS INC. (“INSURELINE”) IS A FULL-SERVICE INSURANCE BROKERAGE. WE SHOP THE MARKET FOR THE BEST HOME INSURANCE POLICY AMONGST CANADA’S LARGEST INSURERS TO QUICKLY GET YOU GREAT COVERAGE AT THE BEST RATE!

Your Information

Property Address

Mailing Address

Lawyer Information

Referrer's Information

CONSENT TO DISCLOSE PERSONAL INFORMATION TO A THIRD PARTY & DISCLOSURE NOTICE OF RECEIPT OF A REFERRAL FEE

CONSENT TO OBTAIN CREDIT INFORMATION