Customer Service Forms

Below are the most commonly requested forms. Some of the forms also include a sample completed for reference.

Please call us at:

Customer Service +1 800 283 9233, ext. 6814 between 8:15 a.m. and 4:30 p.m. Central Time Monday through Friday.

What would you like to do? Form Mail Fax Online
Set up bank draft * Online Bank Draft     Mail
Change my address Online Address Change     Mail
Change my beneficiary Change of Beneficiary     Mail
Change the owner of the contract PDF Change of Owner
(View Sample)
Mail Mail  
Request an Endorsement for Designation of Contingent Owner PDF Change of Contingent Owner
(View Sample)
Mail Mail  
Change or correct my name on the contract PDF Name Change
(View Sample)
Mail Fax  
Apply for a loan on my universal life contract PDF Universal Life Loan
(View Sample)
Mail Fax  
Apply for a loan on my whole life contract PDF Whole Life Loan
(View Sample)
Mail Fax  
Request for Cash Surrender PDF Surrender Form Fax Fax  
Need a new copy of my contract Lost Contract     Fax
Make a withholding election PDF Withholding Election
(View Sample)
Mail Fax  

*Must be completed by bank account holder.