ADVISOR DISCLOSURE STATEMENT
Life insurance agents are required in all provinces to disclose certain information to their clients, in writing. Accordingly, please carefully read thefollowing information. Once signed and dated, I will give you the original and retain acopy in my files as proof that I have complied with the disclosure requirement. Yoursignature on this form simply acknowledges that you received this information. It does notwaive any legal rights you may have.
Compensation
Agents and brokers in the life insurance business are compensated by commissions, bonuses and other inducements, from the insurers whose products we sell. From time-to-time, some companies may offer specificincentives, such as travel rewards, for a limited number of agents/brokers in recognitionof sales made over a specified period of time. Incentive-based compensation is an industry-wide practice and has for many years been a normal form of payment to agents/brokers whosell such products.
As an independent broker, I am bound by the laws governing life insurance agents in
this province and by the Code of Ethics of my professional associationbest suited to your needs, without regard to the compensationpractices of any one company.
When you purchase insurance from me, I will be paid a commission by the insuring
company and may possibly be eligible for other forms of compensation. My role, as an
independent broker, is to work on your behalf as your intermediary, advocate with the
insurance company, to resolve any questions you may have throughout the time you
hold that policy and to ensure your ongoing satisfaction.
When you buy a product from any insurance company listed below, I place this business through OM Financial Inc, aManaging General Agent (MGA) who operates under contract with the insurer. MGAs offer a service to independent agents/brokers on behalf of insurance companiesby assisting with marketing compliance and administrative issues, for example, ensuring the policy information iscomplete before sending it on to the insurer. MGAs do not provide financial or policyadvice to consumers. This is the role of a broker/agent like me.
Potential Conflicts of Interest
I am required to disclose any real or potential conflicts of interest that might exist in my selling insurance to you. At this time I am unaware of any conflicts. I will, however, notify you immediately if I become aware of any such conflicts.
The Products I Sell
I am authorized to sell:
Segregated funds
Universal Life
Whole Life
Term Life
Critical Illness Insurance
Disability Insurance
Annuities
The Companies I Represent
I am authorized to sell insurance products from the followingcompanies:
1. Industrial Alliance
2. Foresters Financial
3. Manulife Financial
4. BMO Insurance
5. Equitable Life
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Agent’s signature Client signature