Filling Out the Enrollment Form

Use the below guidelines and the GIIB/SPIA applications sections to master all necessary requirements when filling out the application.

General Information

• All paperwork completed with applicant and/or owners must be completed face to face.

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Section 1: Information on the Applicant

• The applicant is the person whose funeral is being pre-arranged.
• If the certificate owner is different from the applicant, the owner will receive all correspondence about the certificate.
• It’s a legal requirement to list the physical address if different from the mailing address.
• The applicant’s occupation is required.
• The Social Insurance Number must be used as client identification on contracts that are $10,000 and over.

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Section 2: Beneficiary

• The beneficiary should be a person or estate (next of kin or closest relative recommended).
• Include the beneficiary’s address, phone number and email address (if available).
• If a beneficiary is listed, include the relationship to the applicant.
• DO NOT name the funeral establishment as the beneficiary.
• If the beneficiary section is left blank, the beneficiary will default to the estate of the insured.

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Section 3: Single Premium or Face Amount

• If this application is for a SPIA, write the single premium amount for a death savings plan.
• If this application is for the GIIB, write the face amount for a death insurance plan.

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Section 4: Payment Selection

• Cash cannot be accepted.
• Down payment:
• Down payments are not required; however, if a client wishes to make a down payment, subtract the down payment amount from the total amount. Then multiply the remainder by the applicable Time Pay premium rate.
• Write the down payment on the Single Pay line and the Time Pay premium on the Time Pay line. Add both to indicate the proper amount of the first cheque or draft.
  

  Example: Single Pay/Down Payment ($1,000) + Time Pay ($214.20) = Total Amount of the first cheque or draft ($1,214.20)

• Check the frequency of the payment (Monthly, Quarterly, Semi-annual or Annual) and the payment period (1-, 3-, 5- or 10-year).
• Premiums may be paid by cheque, preauthorized chequing or credit card. (Mastercard or Visa only; American Express is not accepted.)
• If the payment is by credit card, indicate the type and whether the credit card belongs to the applicant, owner or other payor. (If other payor, complete Form 0058-12 OR 0058-13 depending on payment type.)
• Use the box at the bottom of the enrollment form to provide the payor’s credit card information. After sending the information to TLOC, destroy the credit card information to protect the privacy of the payor.
• Cheques/money orders must be made payable to TruStage Life of Canada (TLOC). Double-endorsed cheques will not be accepted and will be returned to the funeral establishment requesting a replacement cheque.
• If PAC is selected, indicate the day future premiums are to be drafted. (First premium will be drafted immediately.)
• Indicate whether the bank account is chequing or savings.
• Attach a voided cheque to the enrollment form (if applicable).
• Subsequent credit card payments will be withdrawn on the same day of the month as the initial payment was processed.
• Calculate Time Pay premiums based on the Total Amount calculated in Section 3, minus any downpayment (indicated on the Single Pay line), using the appropriate rate from the list on the back of the application.

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Section 5: Signature

• The applicant named in Section 1 signs here. If the applicant is not present, there will be no signature in this section.
• Provide the city and date of signature.

Reminder: Any person holding power of attorney can also sign for the applicant on the line provided. This POA signature should be followed by “POA (insert name) acting on behalf of (applicant name).” In this mentioned scenario, the applicant would still be the policy owner. A POA signature does not make the POA the policy owner unless he/she separately has insurable interest.

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Section 6: Policy Owner

• If the owner is someone other than the applicant named, complete this section and obtain the owner’s signature.
• If different from the applicant, the owner must have insurable interest. All certificate information is sent directly to the owner.
• The funeral establishment cannot be named the owner.
• If the payor is not the applicant or the certificate owner, then complete Form 0058-12 Payment Authorization OR 0058-13 Pre-Authorized Chequing (PAC) depending on payment type.

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Section 7: Representative Signature and Information

• Fill out your representative information in this section, including your TruStage ID #.