Forms

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

 Bank Draft Authorization – This form is to authorize electronic 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.

Credit Card/Debit Card 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.

Policy Change and Update Form – This form is used for updating names, addresses and irrevocability.

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

Change of Assignment Form – For use when any changes regarding policy assignment are desired.

 Death Claim by Funeral Home – These forms are used by the assignees or beneficiaries to claim the proceeds of a policy after a death has occurred.