Federal Unlock Form

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Your Facebook profile link
Paste your profile link here
4
How much are you currently set to earn from income and benefits combined in the next 12 consecutive months?* This field is required. Federal Low Income Unlock
Please Select
Please Select
Under $25,000
Under $43,000
Over $46,000
5
Do you, your spouse or your dependents require funds to cover medical expenses?* This field is required. Federal Medical Expense Unlock
Please Select
Please Select
Yes, I/we have medical expenses AT LEAST 20% of my current annual income OR MORE
Yes, I/we have medical expenses and they total LESS than 20% of my current annual income
No, I/we do not have medical expenses
6
Is your locked-in pension plan valued at $13,320 or less with a statement to verify?* This field is required. Federal Low Amount Unlock
Please Select
Please Select
Yes
No
7
Have you permanently departed Canada for at least the past 2 years and acquired tax exempt status from Canada Revenue Agency?* This field is required. Federal Departed Canada Unlock
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Please Select
Yes
No
8
Has a licensed Ontario physician given you an estimated time to survive due to illness/disease?* This field is required. Federal Short Life Expectancy Unlock
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Please Select
Yes, I have a shortened life expectancy
No, I have no shortened life expectancy, officially
9
Once we provide the form(s) and information required for you to easily unlock your locked-in plan (LA, LIF, RLIF, Locked-In RRSP, RLSP or PRPP), you will be required to pay $49.99 + 5% GST = $52.49 CAD by e-transfer - DO YOU AGREE TO PAY IMMEDIATELY UPON RECEIPT OF OUR EMAIL? We will email you within two business hours. No cancellations accepted after submitting this form.* This field is required. Confirmation
Please Select
Please Select
Yes, I agree to pay after submitting this form
No, I do not agree
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