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Consent and Application for Remittance of Disability Benefits to an Insurer (For the use of insurance companies only)

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Disability

Consent and Application for Remittance of Disability Benefits to an Insurer (For the use of insurance companies only)

Insurance companies can use this form to obtain an applicant's consent to the reimbursement of disability benefits to the insurer. This form is also used to file the insurer's application for remittance.

RRQ-004 form. Last update: février 2008.

download, 2 pages, 58 kB
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