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CLICO/BAT Forms

 

EFFA/GAP (Credit Unions/Trade Unions Clients)

STIPS Payment Request Checklist Credit Unions and Trade Unions
Payment Request Application Form This form MUST be completed by eligible credit unions and trade unions to access the Principal Balance on their Short Term Investment Products (STIPs).
(Please print this form on legal sized paper - 8.5 x 14 inches).
Statutory Declaration of Lost Policy Form This form must be completed by eligible credit unions and trade unions which have lost their original STIPs contract and must be witnessed by a Commissioner of Affidavits. The policy will be advertised in the press and final processing will begin six weeks thereafter.
(Please print this form on legal sized paper - 8.5 x 14 inches).
Schedule 1: Deed of Assignment and Declaration of Trust - STIPs This form is to be completed in triplicate in the presence of a CLICO representative and is applicable to STIPs EFPA contracts.
(Please print this form on both sides on legal sized paper – 8.5 x 14 inches).
Schedule 2: Prior Assignment – Institutional Investors - STIPs This form is applicable to EFPA contracts that are assigned and is to be completed in quadruplicate.
(Please print this form on both sides on legal sized paper – 8.5 x 14 inches).
Schedule 3: Acceptance of Government Payment - STIPs This form is applicable to EFPA contracts.
(Please print this form on both sides on legal sized paper – 8.5 x 14 inches).
Schedule 4: Acceptance of Government Payment – Prior Assignment - STIPs This form is applicable to EFPA contracts that are assigned.
(Please print this form on both sides on legal sized paper – 8.5 x 14 inches).

CSI-6 (Credit Unions/Trade Unions Clients)

Advisory to Credit Unions and Trade Unions who hold EFPAs and Mutual Funds (CSI 6)
Schedule for the Processing of Payment Application Forms for Colonial Life Fund Core Series 6 or CSI6
Payment Request Application Form This form MUST be completed by eligible credit unions and trade unions to access the Principal Balance on their Short Term Investment Products (STIPs).
(Please print this form on legal sized paper - 8.5 x 14 inches).
Statutory Declaration of Lost Certificate Form This form must be completed by eligible credit unions and trade unions who have lost their original STIPs contract and must be witnessed by a Commissioner of Affidavits. The policy will be advertised in the press and final processing will begin six weeks thereafter.
(Please print this form on legal sized paper - 8.5 x 14 inches).
Schedule 1: Deed of Trust – CSI 6 This form is to be completed in triplicate in the presence of a CLICO representative and is applicable to STIPS mutual fund CSI 6 contracts.
(Please print this form on both sides on legal sized paper - 8.5 x 14 inches).
Schedule 2: CLICO Prior Assignment – CSI 6 This form is applicable to STIPS mutual fund CSI 6 contracts that are assigned and is to be completed in quadruplicate.
(Please print this form on both sides on legal sized paper – 8.5 x 14 inches).
Schedule 3: Acceptance of Government Payments – CSI 6 This form is applicable to STIPS mutual fund CSI 6 contracts.
(Please print this form on both sides on legal sized paper – 8.5 x 14 inches).
Schedule 4: Acceptance of Government Payment – Prior Assignment – CSI 6 This form is applicable to STIPS mutual fund CSI 6 contracts that are assigned.
(Please print this form on both sides on legal sized paper – 8.5 x 14 inches).

 

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