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How to send your requests to ivari through our secure online tool
Please send your requests for all types of transactions on inforce policies, including claim requirements, to ivari using the following process:
Please send your requests for all types of transactions on inforce policies, including claim requirements, to ivari using the following process:
- Choose the form you need from the list below. By clicking on the link, you will be taken directly to that form. (If you do not see the form you need, you can search for other form(s)).
Note: Currently, only the following provinces accept eSignatures for the Change of Beneficiary form: AB, BC, MB, NB, NL, ON and QC. Clients residing in other provinces will need to download, print, sign, and send the PDF version of this form to ivari through this tool. - Complete the form in full and sign the document.
Note: Files must be sent as PDF, JPEG, JPG, PNG, TIFF or TIF. - Go to our Send Documents tool and follow the instructions to send your files securely to ivari.
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Select from the list below and you will be taken to the form required. If you do not see what you need here, you can search for other form(s).
We recommend that you download/save our PDF forms to your device and use Adobe Reader to complete and save them. By default, your device may open PDF files in your web browser.
Using a browser to complete form fields can cause unexpected results or loss of inputted information. If you do not have Adobe Reader, you can download the latest version for free from https://get.adobe.com/reader/otherversions.
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| Title | Form number | Additional information | Link |
|---|---|---|---|
| “In Good Order” (IGO) Transaction Guidelines – Investment Products Operations Administrative Guide | IP59 | A login is required to download this file. |
Download |
| “In Good Order” (IGO) Transaction Guidelines – Life Operations Administrative Guide | LP1352 | A login is required to download this file. |
Download |
| “In Good Order” (IGO) Transaction Guidelines for WFG – Life Operations Administrative Guide | WFG-LP2152 | A login is required to download this file. |
Download |
| Activities (Ongoing) Questionnaire | CL2141 | Download | |
| Advisor Screening Questionnaire | DCC1698 | Download | |
| Affidavit | IV1783 | Download | |
| Alcohol Usage Questionnaire | UW-ALCQ377 | Download | |
| Allocation Form | PS425 | Download | |
| Amendment between ivari and Broker | DCC546 | A login is required to download this file. |
Download |
| Application to Exercise Purchase Option Rider | PC1771 | Download | |
| Assignment | DCC853 | A login is required to download this file. |
Download |
| Attending Physician’s Statement of Continuing Disability | CL1676 | Download | |
| Aviation/Ultralight/Ballooning/Hang Gliding Questionnaire | UW-AVIQ312 | Download | |
| Broker’s Contract | DCC521 | A login is required to download this file. |
Download |
| Broker’s Contracting Kit | DCC1514 | A login is required to download this file. |
Download |
| Certificate of Incumbency | IP-LP1572 | Download | |
| Certificate of Incumbency – Fillable form | DCC1137 | A login is required to download this file. |
Download |
| Change of Beneficiary Form | PS367 | Download | |
| Claimant’s Statement (for Investment Products) | CL766 | Download | |
| Claimant’s Statement (Life Insurance Claim) | CL213 | Download | |
| Code of Ethical Market Conduct | DCC1388 | A login is required to download this file. |
Download |
| Collateral Assignment | PS391 | Download | |
| Compassionate Assistance Program – Attending Physician’s Statement | CL1724 | Download | |
| Confidential Business Financial Questionnaire | UW-BFINQ361 | Download | |
| Confidential Personal Financial Questionnaire | UW-PFINQ362 | Download | |
| Confirmation of Compliance by Financial Institution Locked-in Pension Funds | IP533 | Download | |
| Contact Information Change | IV1527 | Complete and submit online. |
Download |
| Contingent Owner | PS373 | Download | |
| Contract Requirements and/or Transfer Request | DCC358 | A login is required to download this file. |
Download |
| Conversion Application | LP1285 | Download | |
| Convert a Registered Retirement Income Fund (RRIF) to a Registered Retirement Savings Plan (RRSP) | IP1119 | Download | |
| Corporate/Non-Corporate Entity/Trust Ownership | IP-LP1166 | Download | |
| Critical Illness Attending Physician’s Statement | CL1476 | Download | |
| Critical Illness Claimant’s Statement | CL1477 | Download | |
| CriticalADVANTAGE Claimant’s Statement | CL1007 | Download | |
| Dealer/Nominee Transfer Form | IP1186 | Use this form to transfer from:
|
Download |
| Declaration of tax residency for an entity | IP-LP1601 | Download | |
| Direct Deposit Information | DCC290 | Download | |
| Drug usage questionnaire | UW-DRUGQ378 | Download | |
| Education, Training and Experience Questionnaire | CL2142 | Download | |
| Electronic Funds Transfer (EFT) for express invoice payment | CL2139 | Download | |
| Employer’s Statement Questionnaire | CL2143 | Download | |
| Financial Service Form | IP416 | Download | |
| Five for Life Fund Code Chart | IP1348 | Download | |
| Foreign Death Questionnaire | CL1720 | Download | |
| Foreign Travel Questionnaire | UW-FTQ399 | Download | |
| GROWSafe (GS) / GROWSafe2 (GS2) Fund Code Chart | IP1372 | Download | |
| GROWSafe3 (GS3) Fund Code Chart | IP653 | Download | |
| Identity and Third Party Determination | IP-LP782 | Download | |
| imaxx Guaranteed Investment Funds Application | IP881 | Download | |
| imaxx Guaranteed Investment Funds Information Folder | IP882 | This Information Folder is not complete without the Fund Facts. |
Download |
| imaxxGIF Fund Code Chart | IP884 | Download | |
| Information organizer | LP1750 | Here…there…and everywhere! That’s how many people file their personal and financial information. This can become an issue if an emergency situation arises and you, or someone you trust, has to find and use this information. You can take charge today and ensure that all of your important personal, medical and financial information is located safely, securely and up-to-date should it need to be accessed. |
Download |
| Initial Attending Physician’s Statement | CL1008 | Download | |
| Insurance Application | LP257 | Use this application when applying for:
The fillable life application is for one life, with the option for multiple coverages. If you need to add additional lives, or is a joint plan, we recommend using our e-Application ivari 360. |
Download |
| Insured’s Request for Living Benefits | CL1725 | Download | |
| Insured’s Request for Compassionate Assistance Benefit | CL2111 | Download | |
| Insured’s Statement for Disability and Waiver Claim | CL1009 | Download | |
| Investment Managers Series (IMS) III Fund Base Guarantee* form | IP1292 | *IMS III policies issued on or after February 3rd, 1998 |
Download |
| Investment Objectives & Segregated Fund Options | IP1478 | Download | |
| Investor profile questionnaire | LP1402 | ivari Universal Life Investor profile questionnaire |
Download |
| Investor profile questionnaire – WFG advisors | WFG-LP1222 | Download | |
| ivari Guaranteed Investment Funds – Fund code chart | IP1347 | Download | |
| ivari’s non face-to-face application guidelines | IV1616 | Download | |
| ivari’s non-face-to-face insurance application guidelines – WFG advisors | WFG2012 | Download | |
| ivari’s Underwriting Requirements – Life Insurance Products & Critical Illness Protection Riders | LP2027 | Download | |
| ivari’s Underwriting Requirements Chart for Life Policy Changes | LP1416 | For advisor use. |
Download |
| Job Analysis | CL1464 | Download | |
| Limited Power of Attorney – ivari Investment Product Contracts | IP177 | Download | |
| Limited Power of Attorney – Life Products | LP183 | Download | |
| Managing Broker’s Contracting Kit | DCC1515 | A login is required to download this file. |
Download |
| Market Intermediary Agreement | DCC522 | A login is required to download this file. |
Download |
| Market Intermediary Agreement (MIA) Kit | DCC1513 | A login is required to download this file. |
Download |
| Martial Arts & Combat Sports Questionnaire | UW-MARTSQ1880 | Download | |
| Medical Authorization | UW-LP1094 | Download | |
| Motor Vehicle Authorization (Alberta) | MVR-AB | Note: Some browsers such as Chrome and Firefox use their own PDF viewers, which is incompatible with this form. If you are unable to view the form, please save the form to your computer’s hard drive and open it using Adobe Reader. |
Download |
| Motor Vehicle Authorization Form (British Columbia) | MVR-BC | Download | |
| Motor Vehicle Authorization Form (Manitoba) | MVR-MB | Download | |
| Motor Vehicle Authorization Form (Northwest Territories) | MVR-NT | Download | |
| Motor Vehicle Authorization Form (Quebec) | MVR-QC | Download | |
| Motor Vehicle Authorization Form (Saskatchewan) | MVR-SK | Download | |
| Motor Vehicle Authorization Form (Yukon) | MVR-YT | Download | |
| Motor Vehicle Authorization Form & Letter (Nunavut) | MVR-NV | Download | |
| Motorized Vehicle Questionnaire | UW-DRIVQ379 | Download | |
| Motorized Vehicle Racing Questionnaire | UW-RACEQ401 | Download | |
| Mountaineering Questionnaire | UW-MTNQ398 | Download | |
| Nervous Disorder Questionnaire | UW-NERVQ346 | Download | |
| NN IP Segregated Funds Products Fund Code Chart | IP1373 | Download | |
| Non-Financial Service Form for Existing Clients Only | IP426 | Download | |
| Notice of Cancellation Movable Hypothec without Delivery (Québec) | PS2137 | Download | |
| Notice of Movable Hypothec without Delivery (Québec) | PS1462 | Download | |
| Notice of Transfer of Ownership for Insurance Products | PS371 | Download | |
| Overhead Expense Application Supplement Download | PC1772 | Download | |
| Parachuting/Sky Diving Questionnaire | UW-PARAQ394 | Download | |
| Paramedical Examination Report | UW-LP40 | Download | |
| Physician’s Statement Proof of Death | CL990 | Download | |
| Plan Type Registration Change | IP421 | Download | |
| Policy Change Application | LP386 | Download | |
| Policy Ownership for Corporate & Non-Corporate Entities or Trusts | IP-LP1747 | Download | |
| Policy Service Application | PS339 | Policy Service Application |
Download |
| Politically Exposed Persons and Head of International Organization | IP-LP1165 | Download | |
| Politically Exposed Persons and Head of International Organization for Claims – For beneficiary use only | CL2110 | Download | |
| Pre-Authorized Debit (PAD) for Insurance Products | PS375 | Download | |
| Pre-Disability Self Employed Profile | CL1465 | Download | |
| prosperity term Rate Guide – for WFG | WFG-LP1296 | Download | |
| prosperity Universal Life Fund Code Chart – WFG advisors | WFG-LP1779 | Download | |
| Questions to be Posed when a Spouse Claims as Beneficiary | CL580 | Download | |
| Reinstatement and non-smoker change application for Simplified and Guaranteed Issue policy | LP1990 | A login is required to download this file. |
Download |
| Release of Collateral Assignment | PS2136 | Download | |
| Request for Change of Servicing Representative | DCC369 | Download | |
| Request for Registration as a RRSP | PS341 | Download | |
| Residual Income Loss – Current Earnings Statement | CL383 | Download | |
| Residual Income Loss Prior Earnings Statement | CL356 | Download | |
| Respiratory (Asthma) Questionnaire | UW-RESPQ347 | Download | |
| Scuba Diving Questionnaire | UW-SCUQ395 | Download | |
| Segregated Funds Products Fund Code Chart | IP1490 | Download | |
| Seizure Questionnaire | UW-SEIZQ349 | Download | |
| Simply Simplified Issue and Simply Guaranteed Issue Product Guide | LP2202 | The intent of this guide is to provide you with detailed information about Simply Simplified Issue and Simply Guaranteed Issue products and their features. |
Download |
| Single Premium Immediate Annuity (SPIA) Application | IP-NB151 | Download | |
| Smoking and/or Tobacco Questionnaire | UW-SMOKQ376 | Download | |
| Statement of Persons Insured under Family Insurance Rider | CL578 | Download | |
| Summary of ivari’s segregated funds | IP1371 | Download | |
| Supplemental Health Questionnaire for the Insurance Application | LP-HS2126 | Download | |
| Supplementary Statement of Disability | CL335 | Download | |
| Termination of Assignment | DCC854 | A login is required to download this file. |
Download |
| TermSelect Rate Guide | LP471 | Download | |
| Transfer from a Registered Qualified Policy to an imaxxGIF Contract | IP1212 | IMS I, II, III or GROWSafe 94 segregated fund contracts |
Download |
| Transfer from a Registered Qualified Policy to an imaxxGIF Contract – Electronic Kit | IP903T | Download | |
| Transfer from a Registered Qualified Policy to an ImaxxGIF Contract – Product Comparison Chart | IP1281 | Download | |
| Transfer of Ownership – Investment products | IP1270 | Download | |
| Unclaimed Property Request | LP-IP1451 | Download | |
| Underwriting Height and Weight Chart | LP1403 | Download | |
| Underwriting requirements chart for Critical Illness policy changes | LP1662 | For advisor use. |
Download |
| Universal Life Fund Code Chart | LP946 | Fund codes and available interest options by plan for ivari Universal, EstateAdvantage, WealthAdvantage, AdvantageLife, AdvantageLifePLUS, Assured Life, Transaver, Tplan and Lifetime Saver plans (for use with PS425 – Allocation Form) |
Download |
| Valid industries and occupations | IP-LP1971 | Use this form to determine the valid industries and occupations when employment or industry information is required on an ivari form/ application. |
Download |
| Variable Investment Options (VIO) & General Interest Options (GIO) Universal Life Fund Code Chart | LP946C | Fund codes and available interest options by plan for Challenger, Discovery 2000, ACHIEVER, ENDEAVOUR, HORIZON and OMNILIFE plans (for use with PS425 – Allocation Form). |
Download |