BC 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 consecutive 12 months?* This field is required. BC Low Income Unlock
Please Select
Please Select
Under $25,000
Under $43,500
Over $46,000
5
Are you currently facing foreclosure on your principle residence with a demand letter?* This field is required. BC Foreclosure Unlock
Please Select
Please Select
Yes
No
6
Do you require funds to cover new residential rental and deposit?* This field is required. BC New Tenancy Unlock
Please Select
Please Select
Yes
No
7
Do you, your spouse or your dependents require funds to cover medical expenses or to make alterations to your primary residence to accommodate medical condition?* This field is required. BC Medical Expense Unlock
Please Select
Please Select
Yes
No
8
Is your locked-in pension plan valued at $13,320 or less with a statement to verify? NOTE: If you have more than one BC locked-in account, you do not have to add them together. * This field is required. BC Small Amount Unlock
Please Select
Please Select
Yes
No
9
Have you permanently departed Canada for at least two years AND acquired tax exempt status from Canada Revenue Agency?* This field is required. BC Departed Canada Unlock
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Please Select
Yes
No
10
Are you age 65 years or more with a locked-in pension plan value of $26,640 or less with a statement to verify? * This field is required. BC Age 65+ Plan Value Under 40% YMPE
Please Select
Please Select
Yes
No
11
Has a BC physician given you an estimated time to survive due to illness/disease?* This field is required. BC Shortened Life Expectancy Unlock
Please Select
Please Select
Yes, I have a shortened life expectancy
No, I have no shortened life expectancy, officially
12
Once we provide the form(s) and information for you to easily unlock your locked-in plan (LA, LIF or LIRA), 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.
Please Select
Please Select
Yes, I agree to pay after submitting this form
No, I do not agree
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