Life Insurance Resources & Forms

Download and print the form you need, then mail the completed form to us. Click a form category to show only those forms. If the form you need isn't available below, please contact us.

 

Change of Beneficiary Form - Form #13977

Use the change of beneficiary form to change a primary or contingent beneficiary designation.

Download PDF 

 

Additional Beneficiaries Designation Supplement to Beneficiary Change Request - Form #17963

Use this form to elect Additional Beneficiaries for your contract(s), if you do not have enough space on Form 13977 (Beneficiary Change Request).

Download PDF 

 

Change of Beneficiary for Indexed Survivorship Universal Life Supplemental Insured Rider Form

Use this form to change the beneficiaries for your Indexed Survivorship Universal Life (ISUL) Supplemental Insured Rider.

Download PDF

 

Change of Beneficiary for Indexed Survivorship Universal Life Supplemental Insured Rider Form

Use this form to change the beneficiaries for your Indexed Survivorship Universal Life (ISUL) Supplemental Insured Rider.

Download PDF

 

Trust Verification Form - Form #16541

Used by policy owners, in lieu of the complete copy of the trust, to certify the name, date and trustees of their trust.

Download PDF

Bank Authorization Form - Form #15036

To have your premium payments automatically deducted from your checking account, submit this form and a void check or Specification Sheet from your account. Please contact the Home Office at least ten days prior to your draft date for any changes to an existing Pre-Authorized Check agreement.

Download PDF
 

 

Policy Loan Request Form - Form #15035

Used by policy owners to request a loan from their life insurance policy.

Download PDF 

Change of Ownership Form - Form #15028

Use this form to transfer the ownership of your policy.

Download PDF

 

Authorization to Release Information - Form #17624

Use this form to agree to an information release.

Download PDF

 

Address Change Request - Form #19400

Used by policy owners to notify us in the event of a change to the current address on file.

Download PDF

 

Name Change Request - Form #17884

Used by policy owners to notify us in the event of a legal name change.

Download PDF

 

Request for Co-Ownership - Form #16283

This form is to be utilized any time there will be more than one owner.

Download PDF

 

Pension Plan Verification - Form #17982

Use this form to verify your pension plan.

Download PDF

 

Collateral Assignment – Form #15038

Use this form to assign the rights and privileges of your policy to another person or entity.

Download PDF

 

Arizona State-Specific Policy Application for Reinstatement - Form #175136

Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of Arizona.

Download PDF

 

California State-Specific Policy Application for Reinstatement – Form #191681

Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of California.

Download PDF

 

Connecticut State-Specific Policy Application for Reinstatement – Form #191689

Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of Connecticut.

Download PDF

 

Delaware, District of Columbia and South Dakota
Multi-State Policy Application for Reinstatement
– Form #191692

Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of Delaware, the District of Columbia or South Dakota.

Download PDF

 

Florida State-Specific Policy Application for Reinstatement – Form #191684

Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of Florida.

Download PDF

 

New Jersey State-Specific Policy Application for Reinstatement – Form #191693

Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of New Jersey.

Download PDF

 

North Dakota State-Specific Policy Application for Reinstatement – Form #191687

Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of North Dakota.

Download PDF

 

Multi-State Policy Application for Reinstatement – Form #191694

Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of states that do not require their own variation of the form.

Download PDF

Wellness for Life® Program Rewards Qualification Form -  Form #16489

Used to stay qualified for the Wellness for Life® program. Complete the Wellness for Life® Program Qualification Form and have it signed by your doctor/health care provider at your regularly scheduled routine physical.

Download PDF