Simply fill out the required information electronically, then print, sign and return it at the address on the form.
Please download Adobe Reader 8.0 to view the forms.
Submit address or name changes for yourself or other parties on your contract, or to add, change or delete a third party listed on your policy to receive billing notices
Request a duplicate copy of a lost or destroyed policy or contract
Request annuity payments to be deposited directly into your bank account or to update bank account information for policies or contracts currently having payments deposited via electronic funds transfer
Request automatic withdrawals from your bank account to pay premiums on life or long term care insurance policies, or to update bank account information for policies already drafting premiums
Authorize us to share your information with a third party you designate
Request owner and beneficiary changes on Immediate Annuities issued between 2/14/2000 and 11/13/2005
Request owner, payee or beneficiary changes on any life insurance or annuity contract (except Immediate Annuities issued between 2/14/2000 and 11/13/2005)
Restrict the payout option for any beneficiary of a variable annuity
