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  • Non-smoking Declaration Form

Get Non-smoking Declaration Form

P Box 3517 Station C Ottawa, ON K1Y 4H5 T: 613-236-4061 F: 613-231-2345 1-888-694-9903 www.pipsc.ca pipsc coughlin.ca .O. NON-SMOKING DECLARATION Please complete this form in INK and print clearly.

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How to fill out the Non-smoking Declaration Form online

Filling out the Non-smoking Declaration Form online is a straightforward process that ensures compliance with your insurance requirements. This guide will provide clear instructions tailored to your needs, allowing you to efficiently complete the form in a digital format.

Follow the steps to complete the Non-smoking Declaration Form online

  1. Click ‘Get Form’ button to access the Non-smoking Declaration Form and open it in your preferred online editor.
  2. Begin by entering your policy holder information. Fill in your given name, member surname, and initials. Ensure that you print clearly for easy readability.
  3. Next, provide your street address, referenced number, city, province, and postal code. This information is crucial for identifying your policy.
  4. Indicate your marital status by selecting either 'Single' or 'Married/Common-law'. If applicable, include your spouse’s name only if their smoking status is changing.
  5. Enter your telephone number for contact purposes. Make sure to include the area code.
  6. In the declaration section, confirm that neither you nor your spouse has smoked or used tobacco in any form within the last twelve consecutive months. This is a vital section to ensure the accuracy of your claims.
  7. Sign and date the form where indicated. Your signature certifies that you understand the implications of any misrepresentation in this declaration.
  8. Once all fields are completed, you can save your changes. Choose the option to download, print, or share the completed form as needed.

Complete your Non-smoking Declaration Form online today!

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What happens if I don't disclose to an insurance company that I use tobacco? If you report inaccurate or false information about your tobacco use on an application, an insurer is allowed to retroactively impose the tobacco surcharge to the beginning of the plan year.

plural nonsmokers. : a person who does not smoke tobacco : a person who is not a smoker. Radon poisoning is the leading cause of lung cancer in nonsmokers, ing to the Environmental Protection Agency.

I declare that: I have not smoked tobacco or any other substances, and/or used smoking alternatives, for example: e-cigarettes, vaping, nicotine gum or patches, within the previous 12 months and I have no intention of restarting.

What if I quit smoking or I'm trying to quit? The only way to access more affordable life insurance for smokers is to quit smoking. To qualify for the best non-smoker rates, you can't use tobacco at all. Even after you quit, you'll likely need to wait 1-2 years before you qualify for non-smoking rates.

Generally if you haven't smoked for 12 months or more, you're considered a non-smoker.

'Non-smoking' in life insurance company terms means no use of any tobacco or nicotine products for 12 months, which even includes E-cigarettes, patches or gums. A 'social smoker' or occasional smoker is still classed as a smoker – and charged as a smoker!

Does smoking void a life insurance policy? No. If you're honest about smoking on your life insurance application, smoking will not void a life insurance policy. It's important to be truthful about your smoking history on your application and during your medical exam.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232