Forms

Please note that these forms are intended for the exclusive use of businesses that do not have an address in Québec and individuals.

In accordance with the SAAQ’s language policy, forms intended for SAAQ employees and Québec businesses are only available in French. For a complete list of all our forms, please refer to the French version of this page.

Citizens
TOP 5

Application for Review (PDF, 461.8 ko)

Complete this form if you wish to contest a decision rendered regarding compensation or rehabilitation measures.

Consent of a Person Having Parental Authority (PDF, 102.5 ko)

Complete this form if you are the father, mother or legal guardian of a minor who wants to obtain a driver’s licence or register a vehicle.

Disabled Parking Permit Application (PDF, 359.7 ko)

Complete this form if you have a mobility impairment and you wish to apply for a disabled parking permit.

Power of Attorney (Natural Person Only) (PDF, 905.4 ko)

Complete this form in order to authorize another person to carry out transactions in your name at any of our service outlets.

Vehicle Record Request (PDF, 304.8 ko)

Complete this form if you would like information on a used vehicle.

Driver’s Licence

Application for Review of Suspension of a Licence or the Right to Obtain One (PDF, 130.2 ko)

Complete this form if you have been convicted of impaired driving or excessive speeding and wish to have the suspension of your driver’s licence lifted.

Application for Vehicle Release from Seizure (PDF, 124.2 ko)

Complete this form if you wish to recover your vehicle before the end of the 30-day seizure and impoundment period.

Application for the Driver's Abstract of a Person Residing or Temporarily Living Outside Québec (PDF, 109.3 ko)

Complete this form if you currently reside outside Québec and wish to obtain a copy of your driving record.

Consent of a Person Having Parental Authority (PDF, 102.5 ko)

Complete this form if you are the father, mother or legal guardian of a minor who wants to obtain a driver’s licence or register a vehicle.

Medical sheet – Questionnaire to Complete Before Taking a Driving Course (PDF, 237.4 ko)

Questionnaire to be completed before registering for a driving course in order to determine whether your medical condition could have repercussions on your ability to obtain a driver’s licence.

Power of Attorney (Natural Person Only) (PDF, 905.4 ko)

Complete this form in order to authorize another person to carry out transactions in your name at any of our service outlets.

Registration Form for the Program to Assess and Reduce the Risk of Impaired Driving (PERRCCA) (PDF, 273.8 ko)

Form to be completed by anyone who wishes to register by mail for an assessment with our partner organization, the Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l’Île-de-Montréal.

Vehicle Registration

Application for Exemption from the Prohibition from Putting into Operation, Acquiring, Renting, Leasing or Registering a Road Vehicle (Person Eligible for the Alcohol Ignition Interlock Device Program) (PDF, 155.6 ko) Ce fichier n'est pas conforme au norme d'accessibilité

This form is for persons who are subject to a penalty prohibiting them from putting into operation, acquiring, renting, leasing or registering a road vehicle (ROA penalty) and who wish to have an exemption that would allow them to put into operation, acquire, lease and register a road vehicle or vehicles.

Application for Exemption from the Prohibition from Putting into Operation, Acquiring, Renting, Leasing or Registering a Road Vehicle (With Removable Licence Plates and Vehicle Driven by a Third Party) (PDF, 100.7 ko)

Complete this form if you are a vehicle owner or operator whose licence is currently under penalty and you wish to apply for an exemption that would allow you to put into operation (dealer plates), acquire, lease and register one or more vehicles so that they can be operated by a third party in the course of your business’s activities.

Application for Vehicle Release from Seizure (PDF, 124.2 ko)

Complete this form if you wish to recover your vehicle before the end of the 30-day seizure and impoundment period.

Application for Veteran's Licence Plate Eligibility Certification (PDF, 104.2 ko)

Form that allows an applicant to provide the information required to certify his or her eligibility for a veteran’s licence plate.

Consent of a Person Having Parental Authority (PDF, 102.5 ko)

Complete this form if you are the father, mother or legal guardian of a minor who wants to obtain a driver’s licence or register a vehicle.

Declaration by the Liquidator of the Succession (PDF, 323.5 ko)

Complete this form if you are the liquidator of the succession or the representative of the heirs and you wish to request the transfer of ownership of one or more vehicles belonging to the deceased.

Power of Attorney (Natural Person Only) (PDF, 905.4 ko)

Complete this form in order to authorize another person to carry out transactions in your name at any of our service outlets.

Request for a Mechanical Inspection Certificate (PDF, 175.7 ko)

This form is for the exclusive use of vehicle owners in remote areas who wish to obtain a mechanical inspection certificate.

Vehicle Record Request (PDF, 304.8 ko)

Complete this form if you would like information on a used vehicle.

Traffic Accident

Application for Review (PDF, 461.8 ko)

Complete this form if you wish to contest a decision rendered regarding compensation or rehabilitation measures.

Attestation of Expenses Incurred for Personal Assistance During a Temporary Leave From a Rehabilitation or Residential Centre (PDF, 492.5 ko)

Form to request the payment of expenses for personal assistance during temporary leave from a rehabilitation or residential care centre. The accident victim must be unable to attend to personal care or perform essential activities of daily life without assistance.

Attestation of Expenses for Personal Home Assistance (PDF, 418.3 ko)

Form to request the payment of expenses for personal home assistance if the accident victim is unable to attend to personal care or perform essential activities of daily life without assistance.

Attestation of Income by the Employer (PDF, 471.0 ko)

Form to be filled out by the employer of an accident victim who held full-time or part-time employment at the time of the accident and who is unable to hold that employment or was unable to hold it for more than 7 days after the accident.

Attestation of School Attendance (PDF, 191.3 ko)

Form to be filled out by the educational institution of an accident victim age 16 or older who was a student on a full-time basis.

Attestation of School Attendance – Claim for Death Benefits (PDF, 135.5 ko)

Form to be filled out by the educational institution of an accident victim age 16 or older who was a full-time student or a dependent age 18 or older who was a full-time student.

Authorization to Obtain and Disclose Personal Information in the Case of Property Damage (PDF, 139.6 ko)

Complete this form to authorize the exchange of any information or document between the SAAQ and other persons or organizations concerning property damage involving a vehicle in the event of a hit-and-run.

Authorization to disclose information by telephone (PDF, 363.8 ko)

This form is used to authorize the SAAQ to contact, by telephone, a person you have designated in order to provide general information concerning your claim file. This authorization excludes medical information.

Availability Allowance and Expenses Incurred by the Accompanying Person (PDF, 1.3 Mo)

The person who accompanies an accident victim, or who is required to be present, can use this form to claim an availability allowance, as well as travel, meal and lodging expenses.

Claim for Compensation — For Accident-Related Expenses (PDF, 576.1 ko)

Complete this claim for compensation form if your disability period lasted 7 or fewer days.

Claim for Compensation — For an Inability to Perform Activities and for Accident-Related Expenses (PDF, 367.8 ko)

Complete this claim for compensation form if your disability period lasts for 8 days or more.

Claim for Death Benefits (PDF, 216.2 ko)

Complete this form when a traffic accident results in death.

Claim for Property Damage (PDF, 243.2 ko)

Form for a claim for property damage involving a vehicle in the event of a hit-and-run accident.

Claim for Property Damage – Eligibility Criteria (Guide) (PDF, 84.2 ko)

This guide describes the eligibility criteria for filing a claim with the SAAQ for property damage involving a vehicle in the event of a hit-and-run accident.

Confirmation of Employment Insurance Benefits Lost (PDF, 432.5 ko)

Form to be filled out by a Service Canada centre or a Québec local employment centre when an accident victim was receiving Employment Insurance benefits or an employment-assistance allowance at the time of the accident.

Confirmation of Hiring (PDF, 536.1 ko)

Form to be filled out by the employer of an accident victim who had guaranteed employment that he or she would have held had the accident not occurred.

Direct Deposit Request — Bank and credit union accounts in Canada only (PDF, 472.4 ko)

Complete this form if you receive compensation and wish to register for direct deposit or change your banking information.

Expenses for Travel to Receive Care (PDF, 393.2 ko)

Complete this form to claim travel, meal and lodging expenses incurred in order to receive care or undergo treatment.

Guide to the Claim for Compensation — For Accident-Related Expenses (PDF, 191.4 ko)

Use this guide to help you complete your claim for compensation (disability period lasting 7 or fewer days).

Guide to the Claim for Compensation — For an Inability to Perform Activities and for Accident-Related Expenses (PDF, 293.3 ko) Ce fichier n'est pas conforme au norme d'accessibilité

Use this guide to help you complete your claim for compensation (disability period lasting 8 days or more).

Guide to the Claim for Death Benefits (PDF, 250.9 ko)

Use this guide to help you complete your claim for death benefits.

Job Description (PDF, 733.3 ko)

Form to be filled out by the accident victim’s employer or by the self-employed accident victim to provide a detailed description of the accident victim’s employment and its context. The information provided helps determine whether injuries and limitations prevent the accident victim from holding his or her employment.

Signature of the Electronic Claim for Compensation (PDF, 896.3 ko)

Form to be submitted along with a claim for compensation filed electronically by an applicant other than the accident victim or the parent of a minor child.

Training and Work experience (PDF, 605.7 ko)

This form is used to collect information about the training and work experience of the accident victim.

Road Safety

Declaration of Requirement for Air Bag Deactivation (PDF, 104.5 ko)

Complete this form if you are in one of the risk groups identified in the Air Bag Deactivation folder.

Persons With a Mobility Impairment

Disabled Parking Permit Application (PDF, 359.7 ko)

Complete this form if you have a mobility impairment and you wish to apply for a disabled parking permit.

Administrative

Authorization for the Disclosure of Personal Information by the Société de l'assurance automobile du Québec (PDF, 855.7 ko)

Complete this form to authorize us to disclose information about you to a person you designate.

Authorization to disclose information by telephone (PDF, 363.8 ko)

This form is used to authorize the SAAQ to contact, by telephone, a person you have designated in order to provide general information concerning your claim file. This authorization excludes medical information.

Businesses and Organizations
Driver’s Licence

Authorization for the Disclosure of a Driving Record by the Société de l'assurance automobile du Québec (PDF, 379.2 ko)

Use this form if you are an insurer, employer or vehicle owner and you wish to obtain a copy of a person’s driving record.

Authorization for the Disclosure of a Driving Record by the Société de l'assurance automobile du Québec—With Intermediary (PDF, 317.6 ko)

Use this form if you are an insurer, employer or vehicle owner and you wish to designate an intermediary to obtain a copy of a person’s driving record on your behalf.

Driver's Licence Validity Check (XLS, 78.0 ko) Ce fichier n'est pas conforme au norme d'accessibilité

Checking the validity of more than 5 driver's licences.

Driving Record Search (PDF, 369.0 ko)

Complete this form if you are the representative of a business, organization, municipality, insurance company or government department or body that wishes to obtain a copy of a person’s driving record.

Request for an Attestation - Excerpt from the SAAQ’s records (bodies outside Québec) (PDF, 820.9 ko)

This form allows bodies exercising judicial powers outside of Québec to request an attestation confirming a vehicle’s ownership or whether it is authorized for road use, or an individual’s right to drive.

Vehicle Registration

Application for Exemption from the Prohibition from Putting into Operation, Acquiring, Renting, Leasing or Registering a Road Vehicle (With Removable Licence Plates and Vehicle Driven by a Third Party) (PDF, 100.7 ko)

Complete this form if you are a vehicle owner or operator whose licence is currently under penalty and you wish to apply for an exemption that would allow you to put into operation (dealer plates), acquire, lease and register one or more vehicles so that they can be operated by a third party in the course of your business’s activities.

Request for an Attestation - Excerpt from the SAAQ’s records (bodies outside Québec) (PDF, 820.9 ko)

This form allows bodies exercising judicial powers outside of Québec to request an attestation confirming a vehicle’s ownership or whether it is authorized for road use, or an individual’s right to drive.

Traffic Accident

Attestation of Income by the Employer (PDF, 471.0 ko)

Form to be filled out by the employer of an accident victim who held full-time or part-time employment at the time of the accident and who is unable to hold that employment or was unable to hold it for more than 7 days after the accident.

Attestation of School Attendance (PDF, 191.3 ko)

Form to be filled out by the educational institution of an accident victim age 16 or older who was a student on a full-time basis.

Attestation of School Attendance – Claim for Death Benefits (PDF, 135.5 ko)

Form to be filled out by the educational institution of an accident victim age 16 or older who was a full-time student or a dependent age 18 or older who was a full-time student.

Confirmation of Employment Insurance Benefits Lost (PDF, 432.5 ko)

Form to be filled out by a Service Canada centre or a Québec local employment centre when an accident victim was receiving Employment Insurance benefits or an employment-assistance allowance at the time of the accident.

Confirmation of Hiring (PDF, 536.1 ko)

Form to be filled out by the employer of an accident victim who had guaranteed employment that he or she would have held had the accident not occurred.

Job Description (PDF, 733.3 ko)

Form to be filled out by the accident victim’s employer or by the self-employed accident victim to provide a detailed description of the accident victim’s employment and its context. The information provided helps determine whether injuries and limitations prevent the accident victim from holding his or her employment.

Request for Additional Information Following an Accident (PDF, 408.4 ko)

Complete this form if you are an insurer and wish to obtain additional information about an accident.

Transportation of Goods

Application for Exemption from the Prohibition from Putting into Operation, Acquiring, Renting, Leasing or Registering a Road Vehicle (With Removable Licence Plates and Vehicle Driven by a Third Party) (PDF, 100.7 ko)

Complete this form if you are a vehicle owner or operator whose licence is currently under penalty and you wish to apply for an exemption that would allow you to put into operation (dealer plates), acquire, lease and register one or more vehicles so that they can be operated by a third party in the course of your business’s activities.

Authorization for the Disclosure of a Heavy Vehicle Owner's and Operator's Record by the Société de l'assurance automobile du Québec (PDF, 335.6 ko)

Complete this form if you are the representative of a business or organization that wishes to obtain a copy of a heavy vehicle owner or operator’s driving record.

Excellence Program for Heavy Vehicule Drivers - Registration form (PDF, 473.9 ko)

Complete this form if you are a heavy vehicle driver and wish to register for the Excellence Program.

Notice of Non-Liability an Accident (PDF, 399.4 ko)

Complete this form if you are a heavy vehicle operator and you wish to request that liability for an accident be withdrawn from your or the driver’s conduct record.

Special Travel Permit Application (Correction) (PDF, 290.1 ko) Ce fichier n'est pas conforme au norme d'accessibilité

Special Travel Permit Application (Replacement or renewal) (PDF, 226.4 ko) Ce fichier n'est pas conforme au norme d'accessibilité

Transportation of Passengers

Application for Exemption from the Prohibition from Putting into Operation, Acquiring, Renting, Leasing or Registering a Road Vehicle (With Removable Licence Plates and Vehicle Driven by a Third Party) (PDF, 100.7 ko)

Complete this form if you are a vehicle owner or operator whose licence is currently under penalty and you wish to apply for an exemption that would allow you to put into operation (dealer plates), acquire, lease and register one or more vehicles so that they can be operated by a third party in the course of your business’s activities.

Administrative

Request for Additional Information Following an Accident (PDF, 408.4 ko)

Complete this form if you are an insurer and wish to obtain additional information about an accident.

Request for Information - In accordance with section 610 of the highway Safety Code (PDF, 413.1 ko)

Complete this form if you are an insurer or an investigator and you wish to obtain the ownership history of a vehicle for the purposes of a road vehicle theft or fraud investigation. You can also use this form if you are a creditor and you wish to obtain the name and last known address of a vehicle’s owner for the purposes of an ownership claim.

Request for an Attestation - Excerpt from the SAAQ’s records (bodies outside Québec) (PDF, 820.9 ko)

This form allows bodies exercising judicial powers outside of Québec to request an attestation confirming a vehicle’s ownership or whether it is authorized for road use, or an individual’s right to drive.