Request a copy of your commission statement

This form is valid for the legacy book of business only.

Do you need to complete this form? You may be able to access this information online.

Did you know? You can access copies of your Life Protection Platform commission statements online.

Bank Statement references in the format of Zur Assur 00######/001-001 relate to our Life Protection Platform. Commission statements for these can be accessed online by your firm administrator.

Step 1 of 3

About you (the requestor)

This form must be completed by a firm director or office manager.

All fields, unless otherwise specified, are mandatory. We’ll use this information to validate your identity.