Estate Claim Form – Fill Out and Use This PDF

In Section 1, Beneficiary/Claimant or Executor Information (Mandatory), enter First Name, Middle Initial, Last Name, Street Address, Apt/Unit No., City, Province/State, Postal Code, Country of Residence (For tax reporting), Social Insurance Number (SIN), Date of Birth (MM/DD/YYYY), Phone Number, Relationship to the Deceased and Associated CI Policy/Account Number(s).

Social Insurance Number (SIN)*: under the Income Tax Act, your SIN is required by any person/institution preparing an information slip for you.

In Section 1, select one of these: Named Beneficiary, Joint Owner/Subscriber, Executor/Executrix, Estate Trustee, Financial Trustee for a minor beneficiary, or Other (provide details).

If you are the Financial Trustee for a minor beneficiary, provide the minor beneficiary's details: First Name, Last Name, SIN, Date of Birth (MM/DD/YYYY), Street Address, Apt/Unit No., City, Province/State and Postal Code.

Section 2, Legal Representative Information for the Estate (Executor, Estate Trustee, or Administrator) (Mandatory): complete this section only if the information is different from Section 1, with First Name, Middle Initial, Last Name, Street Address, Apt/Unit No., City, Province/State and Postal Code.

In Section 3, Information about the Deceased (Mandatory), enter First Name, Middle Initial, Last Name, Province/State, Country of Residence, SIN, Date of Birth (MM/DD/YYYY) and Date of Death (MM/DD/YYYY).

In Section 3, select one for the deceased: Married, Common Law*, Never Married, Separated, Divorced or Widowed. *As defined by applicable pension jurisdiction.

Section 4, Settlement Instructions (Mandatory): provide settlement instructions under the applicable option(s).

Under A. Redeem (select one), Electronic Funds Transfer (EFT): provide the Transit Number, Bank Number, Account Number and Account Holder's Name, or attach a copy of a void cheque.

Under A. Redeem, Cheque payable to:, and the Mailing Address (if different from Section 1): Street Address, Apt/Unit No., City, Province/State and Postal Code.

Under A. Redeem, International wire transfer: provide full wire transfer details in Section 5 or attach instructions. A $25 service fee will be applied to the redemption (checked October 31, 2026).

Under B. Transfer (select one), Transfer to new CI account: Client-held (attach CI account application form) or Nominee/Intermediary-held (attach setup blotter).

Under B. Transfer, Transfer to an existing CI account: enter the CI Account Number and the Receiving Account Holder's Name.

Under B. Transfer, provide investment instructions for the receiving account in Section 5. If no investment instructions are provided, the funds will be transferred as is.

Under B. Transfer, Transfer in-cash to another financial institution: enter the Receiving Institution, FundServ A$M Code (if applicable), Street Address, Apt/Unit No., City, Province/State, Postal Code, Account Number, Registration/Plan Type, Receiving Account Holder's Name and Social Insurance Number.

Segregated Fund Death Claims: upon receipt of satisfactory notification of death, CI will switch all account holdings to the front-end Money Market Fund. If no investment instructions are provided, the Death Benefit will be transferred to the new contract as front-end Money Market Fund.

Under C. Continue Original Investment Terms, for a Mutual Fund Registered Retirement Income Fund (RRIF), continue the existing RRIF plan as Successor Annuitant. This applies only if the surviving spouse was named as a sole beneficiary or Successor Annuitant, or if the deceased annuitant's legal representative provides consent.

Under C. Continue Original Investment Terms, for a Mutual Fund Tax-Free Savings Account (TFSA), continue the existing TFSA plan as Successor Holder. This applies if spouse is named as Successor Holder. Otherwise, the transfer will be a new contribution and an RC240 must be filed with the CRA within 30 days of the transfer.

Under C. Continue Original Investment Terms, for a Mutual Fund Tax-Free Savings Account (TFSA), which applies if spouse is named as Successor Holder, Transfer to new CI account (attach CI account application form) or Transfer to existing CI account with the CI Account Number and Receiving Account Holder's Name.

Under C. Continue Original Investment Terms, Segregated Fund Policy: Continue Original Investment Terms (if option is available for the plan/contract). RRSP and locked-in plans will be transferred to a new account. If this section has not been completed upon receipt of satisfactory proof of death, CI will switch all account holdings to the front-end Money Market Fund and the Death Benefit will be triggered.

Under D. Spousal Plans, remove spousal designation where the deceased was named spousal contributor, and enter the CI Account Number(s).

Under E. Joint Plans, remove deceased account holder from joint plan(s), which applies only to Joint Tenants with Rights of Survivorship, and enter the CI Account Number(s). A new account number may be assigned.

Under F. Registered Education Savings Plan (RESP), Individual RESP: Replace RESP subscriber or Joint RESP: Remove RESP subscriber, with Name, Relationship to Beneficiary(ies), Date of Birth (MM/DD/YYYY), Social Insurance Number, Street Address, Apt/Unit No., City, Province/State and Postal Code. New grant forms are required if the primary caregiver is changing.

In Section 5, Additional Instructions, provide investment instructions for the receiving account (from Section 4): Receiving Account Number, Fund Code and Gross Amount OR Percentage*. Total percentage breakdown must equal 100% for each receiving account.

Section 7, Authorization, Discharge, and Indemnity (Mandatory): the undersigned agrees that, upon completion of the directions contained herein, CI Investments Inc. (“CI”), Canadian Western Trust Company (“CWT”) and any of their affiliates (collectively, the “Releasees”), are released and discharged of liability under the policies/accounts held by or insuring the deceased to the extent of the amount paid without taking any further action. Claim must be signature guaranteed by a registered dealer/broker, bank or trust company.

The undersigned hereby indemnifies and agrees to hold the Releasees harmless against all claims of any kind or nature whatsoever nature and by whomever made, inclusive of all legal costs on a solicitor-client basis that may be made against the Releasees arising from this form.

Signature Guarantee Stamp (Mandatory), Signature Guaranteed by: Institution/Dealership, Contact Name and Contact Number.