Estate Claim Form PDF Details

Navigating the aftermath of a loved one's passing involves numerous responsibilities, among which handling their financial matters stands out as particularly daunting. The Estate Claim Form serves as a critical document in this process, offering a structured pathway for individuals to claim assets or funds from accounts or policies where the deceased had investments. This form mandates essential information about the claimant, such as their name, address, and relationship to the deceased, ensuring clear identification and rightful ownership. Furthermore, it delves into details regarding the deceased, including their Social Insurance Number and date of death, to prevent any potential fraud. Claimants have the option to specify how they wish to receive the assets, be it through a cheque, a transfer to an account, or continuing the investment terms under a different policy. Additionally, it includes a section for selecting investments and outlines the authorization, discharge, and indemnity agreement, protecting the investment firm from future claims once the assets are disbursed. Completing this form accurately is pivotal for smooth estate settlement and ensuring that the assets are transferred to the rightful beneficiaries in compliance with the deceased's wishes.

QuestionAnswer
Form NameEstate Claim Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesci estate claim form pdf, ci death claim form, ci investments swess2 estate claim form, ci investments estate claim form

Form Preview Example

Estate Claim Form

Please contact CI Investments Inc. at 1-800-563-5181 for full estate settlement requirements.

A. Information About You

1)Name:

please print or type

2)

Address (in full):

 

 

 

 

 

 

 

 

 

 

postal code

3)

Phone Numbers: Home *

Business *

 

 

 

 

area code

 

area code

4)

Social Insurance Number:

 

5) Date of Birth:

 

dd/mm/yyyy

6)Relationship to the Deceased:

7)Select one of the following for each policy/account being claimed:

a)

 

 

You are the named beneficiary for policy/account number(s)

 

b)

 

 

The Estate is the beneficiary and you are the Estate Trustee for policy/account number(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c)

 

 

There is a minor beneficiary and you are the trustee for policy/account number(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

Minor beneficiary’s name and date of birth:

 

 

 

 

dd/mm/yyyy

B. Information About the Deceased

1)Name of the Deceased:

2)

Social Insurance Number:

3)

Date of Birth:

 

 

 

 

 

 

 

dd/mm/yyyy

3)

Date of Death:

 

 

5)

Place of Death:

 

 

 

dd/mm/yyyy

 

 

 

C. Direction (Information about Manner of Payment)

Please indicate the method of payment:

Cheque

Payable to:

 

 

Address:

 

 

 

 

 

Transfer funds to CI Account

Mutual Fund Account:

 

 

Segregated Fund Policy:

 

*Segregated Funds: Upon receipt of satisfactory notification of death, CI Investments will switch all account holdings to the Front-End Money Market Fund. If Section “D” is not completed, the death benefit will be transferred to the new contract as Front-End Money Market Fund.

Transfer Funds

Institution:

 

 

 

 

 

Address:

 

 

 

 

 

Account Number:

 

Registration:

 

Continue original investment terms in policy number: (Applies to successor annuitant, where applicable)

Continued on page 2

01-08

Estate Claim Form

C. Direction (Information about Manner of Payment)

Continued

Remove deceased account holder from joint plan (Joint Tenants with Rights of Survivorship only)

Spousal Plan Contributor Deceased – Remove Spousal Designation

Special Instructions:

D. Choose Your Investments

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fund Name

 

 

Fund

 

DSC

 

 

Sales

 

 

Gross Amount OR

 

 

 

Number

 

 

(X)

 

 

Commission

 

 

Percentage

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

%

 

$

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Total

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$

%

E. Authorization, Discharge and Indemnity

The undersigned agrees that, upon completion of above direction (C), CI Investments Inc. ("CI"), and any of their affiliates, will be discharged of liability under the policies/accounts held by or insuring the deceased to the extent of the amount paid. The undersigned hereby indemnifies and agrees to hold CI harmless against all claims of whatsoever nature and by whomever made, inclusive of all legal costs on a solicitor and his own client basis, that may be made against CI arising from this form.

Signed At:

 

Date:

dd/mm/yyyy

Claimant’s Signature:

Claim must be signature guaranteed by a registered dealer/broker, bank or trust company

Signature Guaranteed by:

Institution:Contact:

Contact Phone Number: *

Signature Guarantee Stamp

Mandatory

Page 2 of 2

01-08

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So as to fill out this form, be sure to provide the required information in every area:

1. To begin with, when filling in the ci investments estate claim form, beging with the area that contains the subsequent blanks:

Part no. 1 of submitting ci investments estste claim form 11 11

2. Just after the first part is filled out, go to enter the suitable information in all these: Date of Birth, Place of Death, Mutual Fund Account Segregated, Cheque, ddmmyyyy, B Information About the Deceased, Transfer funds to CI Account, Continue original investment terms, Payable to Address, Transfer Funds, Segregated Funds Upon receipt of, Institution Address Account Number, Registration, ddmmyyyy, and Continued on page.

ci investments estste claim form 11 11 writing process described (stage 2)

3. Completing Continued Special Instructions, Remove deceased account holder, Spousal Plan Contributor Deceased, D Choose Your Investments, Fund Name, Fund, Number, DSC X, Sales, Gross Amount OR, Commission, and Percentage is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

Continued Special Instructions, DSC X, and Spousal Plan Contributor Deceased of ci investments estste claim form 11 11

It is easy to make a mistake when filling in your Continued Special Instructions, thus be sure you take another look before you decide to finalize the form.

4. The next subsection needs your attention in the subsequent areas: Total, E Authorization Discharge and, The undersigned agrees that upon, ddmmyyyy, Contact, and Date. Make sure you fill out all required information to go further.

Step # 4 in filling out ci investments estste claim form 11 11

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