Showing 1 to 20 of 54
1. Do you presently use alcoholic beverage? Yes No If yes, please record quantity in each category below (glasses, ounces or bottles, on a daily, weekly or monthly basis…
Reference number: FIND0192
Product type: Forms and Questionnaires
I-MEDICAL HISTORY 1. Symptoms: 2. Date of first symptom: 3. Frequency of attack/episode: 4. Joints affected: 5. Investigation/exam performed 6. Medical diagnosis:
Reference number: FIND0183
Product type: Forms and Questionnaires
Printed Documents Order Form - Individual Insurance To submit your order, please send this form to documents@ssq.ca or press Send button. Important —► Please complete…
Reference number: FIND0072
Product type: Forms and Questionnaires
Basic - 3 illnesses Types of protection Concepts Individual Multi-life Plans T10 T20 T75 T100 T100 paid-up 20 years Enhanced - 25 illnesses Child - 28 illnesses…
Reference number: MIND0065
Product type: Critical Illness
1. How many years have you been racing? 2. What driving course(s) have you taken and for how many years? 3. Racing vehicles you currently use:
Reference number: FIND0196
Product type: Forms and Questionnaires
1. Pilot or pilot student, please specify : Total number of hours flown as a pilot or navigator: Date of last flight: Type(s) of pilot's license held currently: 2.…
Reference number: FIND0195
Product type: Forms and Questionnaires
I.Type of craft: balloon 2. Construction: factory assembled rigid wing 3. Type of flying: advertising student hang glider ultralight plane home built motorized parachute…
Reference number: FIND0199
Product type: Forms and Questionnaires
Consent and Signatures of the payer(s) I (We) authorize the Canadian financial institution mentioned above to provide the insurance company SSQ Insurance Company Inc.…
Reference number: FIND0229
Product type: Forms and Questionnaires
I (we), hereby(ies), surrender to the Company the above contract and ask the cash value in conformity with the above contract dispositions. I (we) acknowledge that the…
Reference number: FIND0208
Product type: Forms and Questionnaires
Beneficiary(ies) - A - life insurance, B - critical illness rider, C - critical illness insurance Indicate both the first name and the last name of the person who will…
Reference number: FIND0205
Product type: Forms and Questionnaires
I declare that the name of: Owner: has been changed for one of the following reasons: wedding separation divorce legal change of name legal adoption error on the…
Reference number: FIND0204
Product type: Forms and Questionnaires
1. Have you ever suffered from chest pain? Date of first occurence: Interval between occurences: 2. If you answered Yes to question 1, is the pain in the left shoulder,…
Reference number: FIND0202
Product type: Forms and Questionnaires
1. Does the child already have a critical illness insurance in force or have any other application pending? If yes, details: 2. Are you aware of any symptoms, signs or…
Reference number: FIND0191
Product type: Critical Illness
1. Identification of the Deceased Person 2. Information on the Deceased Person 3.Tobacco Use 4. Identification of the Claimant 5. Death Benefit Payment Option (Where…
Reference number: FIND0264
Product type: Forms and Questionnaires
This form is required for life insurance policies with a cash surrender value (whole life insurance and universal life insurance), non-registered savings plans (NRSPs)…
Reference number: FRA1748
Product type: Forms and Questionnaires
This form is required for life insurance policies with a cash surrender value (whole life insurance and universal life insurance), for non-registered savings plans (…
Reference number: FRA1737
Product type: Forms and Questionnaires
This form is required to confirm the tax residence status of the beneficiary, for life insurance policies with a cash surrender value (whole life insurance and universal…
Reference number: FRA1866
Product type: Forms and Questionnaires
2. Information on Politically Exposed Persons and Heads of an International Organization (Complete ALL sections) 2A: Foreign Politically Exposed Person (Foreign PEP) 2B…
Reference number: FRA1234
Product type: Forms and Questionnaires
I-MEDICAL HISTORY 1. Medical diagnosis: 2. Episode of: 3. Other medical conditions: 4. Glucometer : 5. Current weight:
Reference number: FIND0187
Product type: Forms and Questionnaires
I-MEDICAL HISTORY 1. Symptoms: 2. Date of first symptom: 3. Frequency of episode: 4. Exams performed: 5. Medical diagnosis:
Reference number: FIND0185
Product type: Forms and Questionnaires