Important instructions to read before you start the registration

This form includes questions about the smoking-related illness and smoking history of the tobacco victim. In the event of the death of the tobacco victim, the form will also ask you questions regarding their estate.

Please note that if you start the form but do not submit it, you will have to start filling in the information from the beginning. After attempting to fill in this form, you will not be able to start it again for a period of 48 hours.

It is therefore important to have all the following information on hand to fill in the form correctly:

• The date of the tobacco victim’s diagnosis, to the best of your knowledge;
• The history of the tobacco victim’s smoking habits, including the brands of cigarettes smoked and their consumption;
• If the tobacco victim has died, the contact information on each of the heirs and their date of birth.
• If the tobacco victim has died and their heirs are to be determined by law, the contact information of each member of the tobacco victim’s family who may potentially inherit (spouse, children, grandchildren, siblings, parents, etc.).

We ask that you submit your documents at the end of this form.

However, if you do not have everything on hand, you can submit them via our secure submission platform on our website. In order to submit documents via the secure submission system, you will need to provide your file number (CAS-12345-123ABC), which will remain the same.

So, if you have answered all the questions but are missing one or two documents, it would be easier for you to submit the form and send us the documents as soon as you have them.