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Service forms library: Traditional form

To download a Service Form, please click on the appropriate form name. You may fax the completed form to us at (800) 278-4117.* Or you can mail your completed form to:

*If you fax this form, please don’t also send it by mail

Note: You must have Adobe Acrobat Reader to view these files. If you do not have this, please visit the Adobe Website to install Adobe Acrobat Reader.

Change of Beneficiary Form
Use this form to change the beneficiary on your policy. Do not use this form if your policy is a family plan or if it has rider insureds.

Change of Beneficiary Form- Multiple Insureds
Use this form to change your beneficiary if your policy is a family plan or if it has rider insureds.

Statement of Trust Form
Use this form to change the beneficiary or ownership of your policy to a Trust.

Check-O-Matic (C-O-M) Request Form
Use this form to set up a payment arrangement in which premiums are paid monthly by automatically deducting the money directly from your checking account.

Dividend Option Change Form
Use this form to request a change in the dividend option of your policy.

Dividend Withdrawal Form
Use this form to withdraw dividends from your policy.

Loan Form
Use this form to request a loan against the cash value of your policy, while still maintaining your insurance coverage.

Loan Repayment Check-O-Matic Form (Whole Life and Universal Life Policies)
Use this form to set up a payment arrangement in which loan repayments are paid monthly by automatically deducting the money directly from your checking account.

Loan Repayment Check-O-Matic Form (Target Life Policies)
Use this form to set up a payment arrangement in which loan repayments are paid monthly by automatically deducting the money directly from your checking account.

Name Change Request Form
Use this form to make most standard change of name requests, i.e.: marriage. This form can only be used to change the name of a person who is already the owner, beneficiary, successor owner, owner's designee or assignee.

Partial Withdrawal Form
Use this form to request a partial withdrawal from your Target, Universal, or Annuity policies.

Transfer of Ownership / Designation of Successor Owner Form
Use this form to make the most standard transfer of ownership requests.

Transfer of Ownership Kit
Use this kit to transfer ownership, setup a Check-O-Matic arrangement to pay your premiums, and change your beneficiary.

IRS Form W-4P - Withholding Certificate for Pension or Annuity Payments
If you are a US person, use this form for all annuity contracts and annuity death claims.

IRS Form W-9 - Request for Taxpayer Identification Number and Certification
If you are a US person, use this form to: certify that the Taxpayer Identification Number (TIN) you are giving is correct (or you are waiting for a number to be issued); certify that you are not subject to backup withholding; or claim exemption from backup withholding if you are a U.S. exempt payee.

If you are a non US citizen residing abroad or a Foreign Entity, use the appropriate form below for annuities, death claims, change of ownership or to refresh information on our files.

IRS Form W-8BEN - Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding (Individuals)

Instructions for the Form W-8BEN
Instructions to complete the IRS Form W-8BEN.

IRS Form W-8BEN-E - Certificate of Status of Beneficial Owner for United States Tax Withholding and Reporting (Entities)

Instructions for the Form W-8BEN- E
Instructions to complete the IRS Form W-8BEN-E.

IRS Form W-8ECI - Certificate of Foreign Person's Claim That Income Is Effectively Connected With the Conduct of a Trade or Business in the United States

Instructions for the Form W- 8ECI
Instructions to complete the IRS Form W-8ECI.

IRS Form W-8EXP - Certificate of Foreign Government or Other Foreign Organization for United States Tax Withholding and Reporting

Instructions for the Form W- 8EXP
Instructions to complete the IRS Form W-8EXP.

IRS Form W-8IMY - Certificate of Foreign Intermediary, Foreign Flow-Through Entity, or Certain U.S. Branches for United States Tax Withholding and Reporting

Instructions for the Form W- 8IMY
Instructions to complete the IRS Form W-8IMY.

To obtain additional Service Forms or to request certain transactions on your policy, please contact a Customer Service Representative at (800) 695 - 4331.