Assignment of Benefits Form
This form allows a person to assign their certificate to a specific funeral home.
Customer Service Request Form
If the certificate owner wishes to make changes to his/her certificate, those changes should be submitted through this form. Those changes include, but are not limited to: beneficiary change, name change, ownership change, duplicate/lost certificate replacement request, age change, surrender for cash value or reduced paid-up coverage. For any change not listed, use Section 10 and detail the request clearly.
PAC Form
This form is used to provide banking information for payment withdrawal from a chequing or savings account. This form is used in addition to the enrollment form when needed and is required if the payor is someone other than the owner or applicant. This form is also required when a client chooses to withdraw funds from two separate accounts.
Payment Authorization Form
This form is used to provide credit card information to authorize payment withdrawal from a Mastercard or Visa account. This form is used in addition to the enrollment form when needed and is required if the payor is someone other than the owner or applicant. This form is also required when a client chooses to withdraw funds from two separate accounts.
Payment Receipt Form
This form is used when a certificate owner provides a payment (regardless of the amount) directly to the funeral establishment/agent/agency in the form of a bank draft, cheque or other bank transaction. This form requires the signatures of both the representative and certificate owner.
Verification of Client Identity Form
This form is used if a certificate owner makes a single payment of $10,000 or more for an individual certificate/annuity. It’s also used if a person conducts a suspicious transaction regardless of the type or amount of the certificate. This form also verifies a person’s identity using a photo ID.
