Life and Accident & Sickness Insurance Forms

The online application system has recently been enhanced and currently applies to all application categories (New, Amendment, Reinstatement, and Reinstatement + Annual Renewal).

Refer to the User Guides before submitting an application to the ICM.

*Life and Accident & Sickness Insurance Applications are Authorized by (sponsored by) the sponsoring insurance company

Online Application for Provincial Examination

Online Application (*all categories)

Supervision Certificate

Certificate of Authority / Non-Resident Endorsement Request Form

Supervision Statement *This form is not a mandatory form under ICM's licensing framework. The form was designed to assist the Life licensed agent, that requires supervision for LIFE insurance, and their supervisor to collect the applicable information depending on the type of insurance being applied for. Completion of this form may require further discussion between the agent requiring supervision and their supervisor.