Taking care of what counts
Forms: Application Forms and Underwriting Requirements
The following application forms and underwriting requirements are available for you to download:
Life insurance and living benefits forms :
Affirmative Application (PDF - 674 Kb)
Deferred Life Annuity Application LifeAnew - LIRA (PDF - 596 Kb)
LTC Application (PDF - 1 817 Kb)
Simplified Second Chance Application (PDF - 565 Kb)
Standard Application (PDF - 1 065 Kb)
Team contact information
General Agent Channel
7333, Place des Roseraies Suite 200
Anjou QC H1M 2X6
Tel.: 514 864-4190
Toll free: 1 866 268-9061
communication.courtage@
lacapitale.com
Denys Clavet
Regional Sales Director, Quebec
Tel.: 418 528-2177
Toll free: 1 800 463-5549
denis.clavet@lacapitale.com
Kim Oliphant
Regional Sales Director, Quebec and Atlantic Provinces
Tel.: 514 687-2962
Toll free: 1 866 268-9061
kim.oliphant@lacapitale.com
Nancy Renaud
Administrative Assistant
Tel.: 514 687-2963
Toll free: 1 866 268-9061
nancy.renaud@lacapitale.com
Raymond Rivest
Vice-President
Tel.: 514 687-2961
Toll free: 1 866 268-9061
raymond.rivest@lacapitale.com
Daniel Sauro
Director of Sales Development, Savings and Investments
Tel.: 418 781-9136
Toll free: 1 866 867-9296
daniel.sauro@lacapitale.com
Julie Sloan
Regional Sales Director, Central and Western Canada
Tel.: 905 407-6509
Toll free: 1 855 407-6509
julie.sloan@lacapitale.com
