For the purposes of this registration form, the term "tobacco victim" refers to the person who has been diagnosed with a tobacco-related illness or illnesses. We ask that only one person register on behalf of the entire estate in the event of the death of the tobacco victim or in the event of any other representation. The initial information requested is therefore that of the tobacco victim, so that we can advise you if there is already a registration in their name.

Succession

To ensure that there are no multiple registrations for the same person, we ask you to enter some information that will enable us to determine whether you have already registered.

Victim