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If you wish to benefit from the direct deposit make sure to attach a void check to this request Optional For an accelerated treatment send us a copy by email at collectif groupefinaction.com or fax a copy to 1-866-927-7979 Mandatory send the original form to GROUPE FINACTION GROUP BENEFITS 72 RUE DE MARTIGNY OUEST SAINT-JEROME QC J7Y 2E9. SECTION 4 DEPENDENT S INFORMATION Last name First name M/F Spouse Children 1 Full time student Yes No SECTION 5 DESIGNATION OF BENEFICIARIES FOR LIFE...
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To fill out reserved for admininsurer, follow these steps:
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Start by entering the required information such as the policyholder's name, address, and contact details.
03
Specify the policy number and effective date of the insurance policy.
04
Provide details about the insured property or individual, including their name, address, and any relevant identification numbers.
05
Fill in the sections designated for policy coverage, such as the type of coverage, limits, and deductibles.
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Indicate any additional endorsements or riders that may apply to the policy.
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Include any relevant claims history or previous insurance coverage details.
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Review the completed form for accuracy and completeness.
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Sign and date the reserved for admininsurer section to acknowledge the accuracy of the information provided.
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Submit the filled-out form to the appropriate administrative or insurance personnel for processing.

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- Agents or brokers who assist in filling out insurance applications on behalf of their clients.
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- Policyholders who want to ensure accurate and complete information is provided to the insurer.
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- Any person or entity seeking insurance coverage who must comply with the insurer's application process.
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Reserved for admininsurer is a section or portion of a form or document that is set aside for use by the administrator or insurer.
The administrator or insurer is required to file reserved for admininsurer.
Reserved for admininsurer should be filled out with relevant information or data specified by the administrator or insurer.
The purpose of reserved for admininsurer is to provide a space for the administrator or insurer to input necessary information related to their role or responsibilities.
Information such as policy details, claims data, and other pertinent information may need to be reported on reserved for admininsurer.
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