Use the below guidelines and the Enrollment Form on the left to master all necessary requirements when filling out an enrollment form.
Please note: Enrollment forms may differ based on the product being sold.

General Information

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

Instructions

1. Information on the Applicant

• The applicant is the person whose funeral is being prearranged.
• 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 also required.

2. Beneficiary

• The beneficiary should be a person or estate (next of kin or closest relative recommended).
• Include the beneficiary’s mailing and physical address(es), 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.

3. Coverage Selection

• Include the base plan in Section A and any other riders or other coverage in the following sections.
• Use the Total line to illustrate the total policy amount.
• Approval is required for a total amount greater than $25,000.
• If the total amount is $10,000 or over, obtain proper client identification.

4. Payment Selection

• Cash cannot be accepted.
• Down payment:
• Calculate Time Pay premiums based on the Total Amount calculated in Section 3, minus any down payment (indicated on the Down Payment line), using the appropriate rate from the list on the back of the enrollment form. Down payments are not required. If a client wishes to make a down payment, subtract the down payment amount from the Total Amount. Multiply the remainder by the applicable Time Pay premium rate listed on the back of the enrollment form. Write the down payment on the Down Payment line and the Time Pay premium on the Time Pay line. Add both to indicate the proper amount of the first cheque or draft.
• Check the frequency (Monthly, Quarterly, Semi-annual, or Annual) and the payment period (1-, 3-, 5-, 10-, 15- or 20-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.

5. Applicant Health Questions

• If the applicant answers “no” to both health questions, the plan will be Preferred Issue (Standard Issue on FPGA 1 Pay)
• If the applicant answers “yes” to either of the health questions or is unable to sign the enrollment form, the plan will be Guaranteed Issue.
• The applicant is not obligated to answer any health question(s). If either question is left unanswered, the plan will be Guaranteed Issue.

6. Assignment of Benefits

• Use this section and check the first box when including assignment information.
• If the contract includes cemetery items that are to be identified as an Eligible Funeral Arrangement, the box must be checked.

7. Signature

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

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

8. Policy (SK)/Certificate Owner

• If the owner of the certificate 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 or 0059-13 depending on payment type.

9. Representative Signature and Information

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