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The PDF fillable form lets you complete a page with information for only one recipient. The page contains three slips.Complete this form to apply for a disability benefit payment from a Manulife life insurance policy. If you're applying at a visa application centre (VAC), they may ask you to re-fill out the form at their internet kiosks. Open Notes and select a note or create a new one. Form Formats. Portable Document Format (PDF) forms. It is very important that you: - send in this form with supporting documents. To make an electronic copy, you can use a scanner, your phone or a digital camera. Scan or take a picture of your document.