American Century Life Insurance Company

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PreArranged Funerals

PreArranged Cremations

Small Value Policies

Investment Annuities

Policy Services

Forms

Bank Draft Form

Visa/Mastercard Form

Change of Address

Change of Beneficiary

Change of Name

Change of Assignment

Release of Assignment

Death Claim

Privacy Statement

Contact Us

 
American Century Life Insurance Company
9120 S Toledo Avenue
Tulsa, OK 74137
918-712-7770
Fax 918-712-7773


Forms


The following forms are available to print and either mail or fax to our office. 

Bank Draft Authorization - This form is to authorize electonic debit entries to your checking or savings account for your premiums.  If you are starting this service or changing banks you should complete this form.

Visa/Mastercard Authorization - This form is to authorize automatic debit charges to your credit card account for your premiums.  If you are starting this service or changing credit card companies you should complete this form.

Change of Address - This is for changing the address of either the policy holder or the owner of the policy.

Change of Beneficiary - This is for changing the beneficiary of your policy.  This is only necessary if the policy is not assigned.

Change of Name - This is for changing the name of either the polcy holder or the owner of the policy. 

Change of Assignment - This is mostly used for Pre-Arranged Funerals and Cremations when you change the provider you have chosen.  

Release of Assignment - This is used by the assignee to acknowledge the release of thier assignment on a policy and removing their ability to claim benefits.

Death Claim - This form is used by assignees or beneficiaries to claim the proceeds of a policy after a death has occurred.