Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • 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.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

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!

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

Smoking Exemption Declaration Form - Department of...
I own or operate a retail store that does not share space with any other establishment and...
Learn more
Declaration of Tobacco Use or Non-Tobacco Use Form
The maximum premium surcharge is $90 per family per month. Members must declare if they...
Learn more
Provider Manual - Health First Network
12 to 18 Month Child Health Check-Up Tracking Form 36. 18 Month ... Stop Smoking, Drug and...
Learn more

Related links form

EMPLOYMENT APPLICATION - Rolling Hills Casino Online Tc Application Form Pune University External Student Incident Report - Opticians Association Of Canada Compassionate Release Petition Form

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

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.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Non-smoking Declaration Form
Get form
  • 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
  • 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
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • Blog
  • Affiliates
  • Contact Us
  • Delete My Account
  • Site Map
  • Industries
  • Forms in Spanish
  • Localized Forms
  • State-specific Forms
  • Forms Kit
  • Real Estate Handbook
  • All Guides
  • Notarize
  • Incorporation services
  • For Consumers
  • For Small Business
  • For Attorneys
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
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
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • 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
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
© Copyright 1999-2026 airSlate Legal Forms, Inc. 3720 Flowood Dr, Flowood, Mississippi 39232
  • Your Privacy Choices
  • Terms of Service
  • Privacy Notice
  • Content Takedown Policy
  • Bug Bounty Program