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Get Canada Sun Life Authorization To Furnish Information (4793 DC-106) 2016

MAinsurance.com Please PRINT clearly. 1 Clear Member and spouse information Online application confirmation number (REQUIRED) Member s first name Ref # (if known) Middle initial Last name Date of birth (dd-mm-yyyy) Spouse s first name (if applying) Middle initial Last name Date of birth (dd-mm-yyyy) 2 Authorization I authorize Sun Life Assurance Company of Canada and/or New York Life Insurance Company, its agents and service providers to collect, use an.

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