Insurance - Forms

* The forms can be sorted by clicking on any of the following column headings: Form No, Form Name or Category. * To see a complete listing of forms, please enter your username and password and login to Equinet
Form No.	Form Name	Category
	Authorization to Release Evidence to Medical Advisor (français)	Underwriting
14	Assignment of Policyowner Trading Authorization (français)	Life & Health Admin Savings & Retirement
16MR	Claimant's Statement (Disability Claim) (français)	Claims
34	Discharge of Maturity	Life & Health Admin Savings & Retirement
42	Request for Policy Documentation (français)	Life & Health Admin
46	Policy Loan OR Premium History Request	Life and Health Policy Change
340	Equity Dividend Option - Application	Underwriting
341	341 Consent and Authorization for Release of Medical Information to Advisor (français)	Underwriting
342	Equity Dividend Option	Underwriting
345	Third Party, Corporate and Politically Exposed Person Form (français)	Life and Health Policy Change Savings & Retirement Underwriting
347	Critical Illness PreQualifying Questionnaire (français)	Underwriting
348	Equimax Short Form Single Life Application (français)	Life and Health Policy Change Underwriting
349	Application for Juvenile EquiLiving Critical Illness Insurance (français)	Critical Illness Insurance
350	Application for Life And/Or Critical Illness Insurance (français)	Critical Illness Insurance Life and Health Policy Change Underwriting
351	Short Form Single Life Application (March 2010) (français)	Underwriting
370	Declaration of Insurability (Reinstatement) (français)	Life & Health Admin Life and Health Policy Change Underwriting
374	Application for Change (français)	Life and Health Policy Change
378	Pre-Authorized Debit Plan (français)	Life & Health Admin Savings & Retirement
455	Annuity Settlement Options	Life & Health Admin Savings & Retirement
558	Request for Withdrawal of Dividends, Change in Option, or Premium Offset (français)	Life & Health Admin
563	Attending Physician's Statement (ongoing) (français)	Administration Forms Disability Claims
570	Declaration as to Loss of Policy (Life/Annuity Death Claims) (français)	Claims
671BCF	Beneficiary Change Request Form (français)	Life & Health Admin Savings & Retirement
671NOC	Name and Ownership Change Form (français)	Life & Health Admin Savings & Retirement
680	Policy Loan Agreement (français)	Life & Health Admin
681	Request for Termination (français)	Life & Health Admin Life and Health Policy Change Savings & Retirement Underwriting
682	Claimant's Statement (Death) (français)	Claims Savings & Retirement
683	Proof of Death - Physician's Statement (français)	Administration Forms Disability Claims
693UL	Reallocation of Funds - Universal Life (français)	Life & Health Admin
1022	Money Order / Bank Draft (français)	Life & Health Admin Savings & Retirement
1024	Guide to Individual Underwriting	Underwriting
1322	Aviation Questionnaire (français)	Underwriting
1323	Financial Questionnaire - Business (français)	Underwriting
1324	Financial Questionnaire - Personal (français)	Underwriting
1325	Drinking Habits Questionnaire (français)	Underwriting
1326	Drug Use Questionnaire (français)	Underwriting
1327	Foreign Travel and Residence Questionnaire (français)	Underwriting
1328	Motor Sports Questionnaire (français)	Underwriting
1329	Mountain Climbing Questionnaire (français)	Underwriting
1330	Nervous Disorder Questionnaire (français)	Underwriting
1331	Respiratory Questionnaire (français)	Underwriting
1332	Skin and Scuba Diving Questionnaire (français)	Underwriting
1333	Parachuting or Sky Diving Questionnaire (français)	Underwriting
1335	Ultra Light Planes and Hang Gliding Questionnaire (français)	Underwriting
1343	Evidence of Insurability (français)	Life and Health Policy Change Underwriting
1345	Preferred Underwriting Classifications	Term Underwriting
1390	Life & Health Supply Order Form (français)	Life & Health Admin

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