Application Form:  Insurance company application for rating program approval for basic coverage for vehicles other than private passenger under Section 19 of the Automobile Insurance Premiums Regulation.

Fillable PDF:  As of July 7, 2006, this pdf form is now "fillable".  The instructions are available on the upper right corner of the form.  You will need Acrobat Reader 6.0 or higher to complete this form online.  If you don't have Acrobat Reader or need to upgrade, click here to download this free program.

Steps:

Complete an application form (link below) and send it to:

Automobile Insurance Rate Board Room 200, Terrace Building 9515 - 107 Street Edmonton, Alberta, T5K 2C3 airb@gov.ab.ca Fax number: (780) 644-7771

Please note: The fee to submit an application under Section 19 of the Automobile Insurance Premiums Regulation is $500 plus any actual costs of engaging the services of an actuary for the purposes of carrying out the review. OK - Download Application Form

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