Life Forms

Change of Address Form 
Use this form to change your address or phone number.

Authorization for the Use and Disclosure of Information 
Use this form to grant covered entity permission to release information to designated individuals.

Accelerated Death Benefit Request 
Use this form to make a request on your Accelerated Death Benefit on your policy (not applicable on all policies).

Policy Values Request Form 
Use this form to surrender or take out a loan or partial withdrawal on your policy.
Policy Values Request Form for Oregon 
Oregon customers - Use this form to surrender or take out a loan or partial withdrawal on your policy.

Request for Service Form - Funeral Home 
Customers who have a Funeral Home Policy - Use this form to change your name, update your address, change your beneficiary, or request a duplicate policy.
Request for Service Form for Oregon - Funeral Home 
Oregon customers who have a Funeral Home Policy - Use this form to change your name, update your address, change your beneficiary, or request a duplicate policy.

Request for Service Form 
Use this form to change your name, update your address, change your beneficiary, or request a duplicate policy.
Request for Service Form for Oregon 
Oregon customers - Use this form to change your name, update your address, change your beneficiary, or request a duplicate policy.

Absolute Assignment Form 
Use this form to change the ownership of your policy. This form is NOT to be used to assign benefits to others.

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