OTHER SERVICES

Auto/ Property/ Corporate/ Business Liability Insurance:

Full Name *

Date of Birth *

Email *

Mobile Number *

City & Province of Residence *

Preferred Languange *

English

Français

Both / Either

Client’s Insurance Policy Expiry Date:

Client’s Insurance Request (select all that apply)

Auto

Property(Home, Condo, Tenants)

Professional Insurance

Is there any other information you would like to include

Preferred Consultation Method:

Zoom / video call

In-person

Consent to be contacted
I agree that a representative from JK Infinite Solutions may contact me by phone, email, or text message to discuss my financial needs and potential solutions.

CASL / marketing consent
I would like to receive educational content, invitations to webinars, and updates about financial strategies and services. I understand I can unsubscribe at any time.

This form is for quotation purposes only and does not guarantee coverage. All policies depend on underwriting approval and provincial regulations. Do not provide SIN or sensitive account details.