Transcription of Life Insurance Application
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Life Insurance Application
LifeInsurance ApplicationLife Insurance89604 (08/2008)89604 (08/2008)COLLECTION AND USE OF PERSONAL INFORMATIONC ollecting your personal informationWe (RBC life Insurance Company) may from time to time collect information about you such as: information establishing your identity (for example, name, address, phone number, date of birth, etc.) andyour personal background; information related to or arising from your relationship with and through us; information you provide through the Application and claim process for any of our Insurance products andservices; and information for the provision of products and may collect information from you, either directly or through representatives. We may collect and confirmthis information during the course of our relationship. We may also obtain this information from a variety ofsources including hospitals, doctors and other health care providers, the MIB, Inc.
89604 (08/2008) Please note that this paragraph is not applicable if this form is submitted by an independent representative or a representative that is attached to a firm other than RBC Insurance®
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