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  • Non-smoking Declaration Form

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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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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.
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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
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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