Broker Forms

All English forms are available in fillable PDF format. You can also print them as well.
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Choose a section:
- Change / Reinstatement / Conversion Applications
- Underwriting Supplemental Forms
- Annuity Applications
- Customer Service Forms
- Claim Forms - Life Policies
- Claim Forms - Critical Illness Policies
Change / Reinstatement / Conversion Applications
- Change/Reinstatement/Conversion Application (07/2022)
- Change/Reinstatement/Conversion Application (for policies issued prior to January 4, 2022)
- Application for Change (Non-Medical) (07/2022)
- Application for Change (Non-Medical) (for policies issued prior to January 4, 2022)
- Quick Reinstatement Application (01/2022)
- Amendment to Life Application or Change/Reinstatement Application (03/2014)
Underwriting Supplemental Forms
- Voluntary Consent Form - Favourable Genetic Testing (10/2022)
- Alcohol Usage Questionnaire (04/2020)
- Arthritis Questionnaire (04/2020)
- Attention Deficit DisorderQuestionnaire (04/2020)
- Aviation Questionnaire (04/2020)
- Back Pain Questionnaire (04/2020)
- Backcountry Snowmobiling Questionnaire (04/2020)
- Blood Pressure Questionnaire (04/2020)
- Blood Pressure Recheck (04/2020)
- Bronchitis or Asthma Questionnaire (04/2020)
- Cancer Questionnaire (04/2020)
- Chest Pain Questionnaire (04/2020)
- Diabetic Questionnaire- Applicant (04/2020)
- Drug Usage Questionnaire (04/2020)
- Financial Questionnaire (04/2020)
- Foreign Residence and Travel Questionnaire (04/2020)
- Gastrointestinal Disorder Questionnaire (04/2020)
- Heart Murmur Questionnaire (04/2020)
- Hypertension Questionnaire (04/2020)
- Motor Sports Racing Questionnaire (11/2020)
- Mountaineering Questionnaire (04/2020)
- Nervous Disorder Questionnaire (04/2020)
- Scuba Diving Questionnaire (04/2020)
- Seizure Questionnaire (04/2020)
- Skydiving or Parachuting Questionnaire (04/2020)
- Tobacco Usage Questionnaire (04/2020)
Annuity Applications
- Guaranteed Investment Annuity (Non-Registered) Application (11/2022)
- Guaranteed Retirement Annuity (RSP) Application (11/2022)
- Individual Savings Plan Allocation of Contributions (11/2022)
- Retirement Income Fund (RIF) Application (11/2022)
- Single Premium Immediate Annuity Application (12/2021)
- Registered Investment Transfer Form (11/2022)
- Non-Registered Investment Transfer Form (11/2022)
Customer Service Forms
- Address Change (11/2022)
- Annuity Withdrawal Form (12/2021)
- Agent of Record/Servicing Agent Change (05/2020)
- Banking Change / Pre-Authorized Debit Application (10/2022)
- Beneficiary Change (11/2022)
- Collateral Assignment of Policy (05/2020)
- Contingent Policy Owner Form (05/2020)
- Direct Deposit Enrollment Form (05/2020)
- Dividend Change (05/2020)
- Name Change (11/2022)
- Policy Loan Application (11/2022)
- Policy Termination Request (05/2020)
- Pre-Authorized Debit Agreement Cancellation Request (01/2022)
- Letter of Authorization for Non-Residents (05/2020)
- Request for Duplicate Policy (05/2020)
- Release of Assignment (05/2020)
- Transfer of Ownership (11/2022)
- Declaration of Tax Residence for Individuals (2022)
- Declaration of Tax Residence for Entities (2022)
- Universal Life Withdrawal Form (05/2020)
- Life Insurance Replacement Declaration (08/2019)
Claim Forms - Life Policies
To be completed by Claimant:
- Continuing Disability - Claimant's Statement (07/2020)
- Death Claim - Claimant's Statement (07/2020)
- Waiver of Premium Benefit - Claimant's Statement (07/2020)
To be completed by Physician:
- Continuing Disability - Attending Physician's Statement (07/2020)
- Death Claim - Physician's Statement (07/2020)
- Initial LTD Benefit - Attending Physician's Statement (07/2020)
Claim Forms - Critical Illness Policies
To be completed by Claimant:
- All Illnesses - Claimant's Statement (06/2020)
To be completed by Physician: If the Insured’s Critical Illness is not listed here, please use the Attending Physician Statement - General Form.
- Attending Physician Statement - General (06/2022)
- Alzheimer's Disease - Physician's Statement (06/2020)
- Benign Brain Tumor - Physician's Statement (06/2020)
- Blindness - Physician's Statement (06/2020)
- Cancer - Physician's Statement (06/2020)
- Coronary Artery Bypass - Physician's Statement (06/2020)
- Deafness - Physician's Statement (06/2020)
- Heart Attack - Physician's Statement (06/2020)
- Kidney Failure - Physician's Statement (06/2020)
- Multiple Sclerosis - Physician's Statement (06/2020)
- Organ Transplant - Physician's Statement (06/2020)
- Paralysis - Physician's Statement (06/2020)
- Parkinson's Disease - Physician's Statement (06/2020)
- Stroke - Physician's Statement (06/2020)