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Reference Material & Forms

application for express elite life insurance

Express Elite Term Insurance

Providing you with the flexibility to offer your clients who are in excellent health, our lowest rates for No Medical with up to $750,000 in Term coverage.

application for critical illness insurance

Critical Illness Insurance

Offer your clients the choice to unbundle or bundle cardiac and cancer conditions, making our CI Insurance more accessible. Up to $100,000 in coverage.

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Why use a paper application when you can go the “e-route”? It’s faster and so is the issuing of policies. Save time and simplify your workday.

Application for Change to Non-Smoker Rates

Application for Reduced Paid – UP & Term Conversion

Application to Add Hospital Cash Rider

Beneficiary Designation Form

Child Term Benefit Questionnaire

COVID-19 (Coronavirus) Exposure Questionnaire

Credit Card Authorization Form

Ownership Change Form

PAC Plan Authorization And Agreement Form

Policy Change Application

Third Party Determination Questionnaire

Supply Order Web Form

Claim Form

Life Claimant Statement Contestable
Complete this form if the death occurred in first two years of the policy or if the policy was reinstated in the last two years.

Life Claimant Statement Non Contestable
Complete this form if the death occurred in policy year three or after, and the policy was not reinstated in the last two years.

To ensure timely handling of your claim, it is important that your submission contain all necessary information requested in the Claimant’s Statement. Completed, signed, witnessed and dated forms can be sent to Foresters at

789 Don Mills Road
Toronto, ON M3C 1T9

Declaration of Tax Residence

Effective July 1, 2017, Clients with international tax status purchasing a Whole Life Insurance policy with cash value through Canada Protection Plan are required to provide a “Declaration of Tax Residence”.

This is a requirement under Canadian law which obligates financial institutions to provide certain information to the Canada Revenue Agency (CRA), which in turn transfers that information to the applicable international tax agencies. We will not settle applications for Clients with international tax status without the completed Declaration of Tax Residence form.

A “Declaration of Tax Residence” certifies the policy holder’s country of tax residence and includes their TIN(s) and date of birth. Please refer to the below applicable CRA form RC520 – Declaration of Tax Residence for Individuals – Part XIX of the Income Tax Act or RC521 – Declaration of Tax Residence for Entities – Part XIX of the Income Tax Act.

The declaration will also be required for certain inforce policy forms such as conversions and change of owner.

To comply with CRS, we will require the completion of:

We will not settle applications without the completed declaration. This document is only required on Applications dated 10/16. All Applications with 10/17 date do not require this declaration form. 

Please send all executed “Declaration of Tax Residence” forms to Canada Protection Plan Head Office along with the application(10/16) or email us at

Financial institutions cannot provide advice about tax residency to clients. If your Client is unsure about their tax residency status, they should consult a tax advisor.

Sample Policy Contracts

The following sample policy pages are provided for reference only. They may be incomplete and/or may not reflect recent updates. To determine exact terms and conditions for a particular client, please refer to the actual policy issued to that client.