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Forms

All the forms for your insurances gathered here.

e-volulife

e-volulife pension and death

Fill in this form, sign it and return it to AG Employee Benefits to the attention of your plan manager at Boulevard Emile Jacqmain 53, 1000 Brussels.

New enrolment          
EN - FR - NL 
            
Change the affiliate's personal choices                                      
EN - FR NL

Death
Use the Notification of death if you have to report the death of an affiliate.

Print the form and complete your section. 

Ask the beneficiary to complete the section about them, sign the form and send it to you with: 

an extract of the death certificate of the affiliate including the place and date of the death, 

a photocopy of the front and back of the identity and SIS cards of the beneficiary(ies), 

a notarial certificate, if the beneficiary(ies) (other than the spouse) was(were) not designated by name. The certificate should provide the last names, first names, dates of birth, civil status and addresses of the legal heirs of the affiliate, 

if one or more beneficiaries is(are) (a) minor(s) and no longer have a mother or father: the special authorisation of the judge of the peace authorising the tutor to collect the funds, 

if the services provided by the contract must be converted into an annuity: a certificate of life of the beneficiary(ies), 

if the affiliate's tax residence or the location of their wealth is abroad: a tax certificate. You must provide the “tax residence or location of wealth abroad” document in the language of the country in question for this purpose.

EN - FR - NL - DE

Tax residence or location of wealth abroad
EN - FR - NL - DE - ES


Beneficiary(ies) in the event of death

Designation/change in beneficiary(ies) in the event of death
The affiliate must fill in and sign the form. It must then be sent directly to AG Employee Benefits at the address provided on the form.        
EN FR - NL - DE

Explanatory note in the event of the designation/change in the beneficiary(ies) 
EN FR - NL

Waiver of the application of Article 110/1 LCAT (2nd pillar)
 FR - NL                                                 
                   
Waiver of the application of Article 110/1 LCAT (3rd pillar) 
FR - NL                                               


Early retirement:    

Use the Notification of Liquidation form if your affiliate retires or takes early retirement.
Print the form and complete the section about you. 
Ask the affiliate to complete the section about them, sign the form and send it to you with a photocopy of the front and back of their identity and SIS cards. 
If the affiliate's tax residence or the location of their wealth is abroad: tax certificate. You must provide the “tax residence or location of wealth abroad” document to the affiliate in the language of the country in question.
  

  
Notification of liquidation

EN - FR - NL - DE

Notification of early surrender
EN - FRNL - DE 

Tax residence or location of wealth abroad
EN - FR - NL - DE - ES
 
Notification of departure from a plan
Use the Departure form if the employment contract of your affiliate is terminated for a reason other than retirement, early retirement or death.
 EN - FR - NL - DE

Sign a webagreement (for the employer)
 EN - FR - NL

Sign a webagreement (for the affiliate)
 EN - FR - NL