Print this pageDealer Forms
Searching for a form? Download our most commonly requested dealer forms* here.
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Claim Forms
- Proof of Death - Physician's Statement (Creditor Insurance)
- Life Insurance Claimants Statement (Creditor Insurance)
- Disability Insurance Claimants Statement (Creditor Insurance)
Cancellation Forms
- Customer cancellation at dealership (Creditor Insurance)
- Request For Refund (Creditor Insurance)
- Surrender Value Request of Premium on Repossessed/Written Off Vehicles (Creditor Insurance)
- Cancellation Form (All Provinces except Quebec - Extended Warranty)
- Notice of Cancellation - After 10 Days (Quebec only - Creditor Insurance)
- Notice of Cancellation - After 10 Days (Quebec only - Replacement Insurance)
- Notice of Cancellation - Within 10 Days (Quebec only - Replacement Insurance)
Other Forms
- Waiver for Life, Critical Illness and Disability (Creditor Insurance)
- Information Disclosure Form (Quebec Only - Replacement Insurance)
- Ontario Retail Sales Tax Certification Form (Ontario Only - Creditor Insurance)
- Creditor Life, Critical Illness, Sickness & Accident Remittance
*Please be advised that on June 30, 2012, Industrial Alliance Pacific Insurance and Financial Services Inc. and Industrial Alliance Insurance and Financial Services Inc. amalgamated and now operate as one entity.