Actuel Page 1 Page 2 Aperçu Personal information on this application form is collected under Sections 345, 346, and 347 of the Insurance Act, as it relates directly to and is necessary for the purposes of applying for a certificate of authority to act as an insurance adjuster. If you have any questions about this collection of personal information, you may contact the Superintendent of Insurance, Financial and Consumer Services Division, 902-368-4550. Identification Prénom Initiale Nom Adresse 1 Adresse 2 Ville, municipalité, communauté Province Code postal Exemple : C1B 0X1 ou 12345 Pays Numéro de téléphone Exemple : 902-555-5555 Adresse courriel