MONTHLY INCOME. Upon receipt by Standard of notice and satisfactory proof that any Member, while insured under the group policy, shall have become disabled as a result of Physical Disease, Injury, Pregnancy or Mental Disorder, and that during the period of such disability, such Member shall have been under the regular care and attendance of a physician, Standard will pay periodically the Monthly Income in accordance with the Schedule of Insurance during the continuance of such disability, subject to the Exceptions and Limitations of this Section, and subject to the following provisions:
MONTHLY INCOME. You will be paid a salary of Eight Hundred Three Thousand and Four Hundred Patacas (MOP803,400.00), PER MONTH, (for reference purposes only, equivalent to USD1,200,000.00 per annum). Salary will be reviewed annually in accordance with the Company’s compensation policies.
MONTHLY INCOME. ALL income reported below must be verified if applying for an “Affordable Unit”. Please attach a copy of the Revenue Canada Notice of Assessment for the most recent full year. Old Age Security and G.I.S. $ per month Canada Pension $ per month Alberta Seniors Benefit $ per month Company Pension $ per month Disability Pension $ per month War Veterans Allowance $ per month War Disability Pension $ per month Employment Income $ per month Social Assistance $ per month AISH $ per month Other Income: Specify $ per month TOTAL $ per month Employment Income If you or your co-applicant have employment income(s), please state the name(s) and address of the employer(s) Employer: Telephone #: Address: Co-Applicant Employer: Telephone #: Address: Housing Information Do you currently : Rent Own Live with Family Other (explain): Present rent or house payment is $ per month, plus $ for heat and $ for light, water and sewer. Length of time at present address: If renting, name of your present Landlord Telephone #: Is your present accommodation a: House Apartment Hotel Rooming House Other Number of bedrooms in present accommodation: Do you share accommodations? Yes No Number of person(s) sharing your present accommodation: Adults: Children: Does any member of your household require accommodation adapted for special needs (wheelchair)? Yes No Please give details Do you require a barrier free suite? Yes No Please give details Do you require underground parking? Yes No Surface parking? Yes No No Pets Allowed Reasons for wanting to move: If you have been given a “NOTICE TO VACATE”, please submit a copy of the notice and state the reason for the eviction: Have you been evicted from any rental premises in the past ten years? Yes No Please provide details about your tenancy history, name of most recent landlord with contact information, and details about any past eviction ADDITIONAL PERSONAL INFORMATION We ask that you also provide us with the following information, which will be helpful to our staff in case of emergencies. NEXT OF KIN: (or closest friends) Name Telephone #: Address Relationship: Name Telephone #: Address Relationship: Do you have a Will? Yes No Location of Will Name of Executor: Telephone #: Address of Executor: Family Doctor: Telephone #: Personal Reference: Name Telephone #: Other related information you wish to provide Please state any physical disabilities or significant illness: Applying for: Templemont Place Glenway Gate The information on this form is being ...
