Variable Life Forms

The best way to fill out or make changes to your forms is our Self-Service channel on my account. If you need further assistance, we recommend calling our Customer Service Center.

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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.

Call Us: 1-800-225-5695

Mail or Fax

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.

Call Us: 1-800-225-5695

Mail or Fax

Statement of Trust Form

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

Call Us: 1-800-225-5695

Mail or Fax

Transfer of Ownership / Designation of Successor Owner Form

Use this form to request a transfer of ownership and/or designate a successor owner.

Call Us: 1-800-225-5695

Mail or Fax

Transfer of Ownership Kit

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

Mail or Fax

Loan Request Form

Use this form to request a Loan against your policy.

Call Us: 1-800-225-5695

Mail or Fax

Partial Withdrawal Request Form

Use this form to request a Partial Withdrawal. Do not use this form for a Full Surrender.

Call Us: 1-800-225-5695

Mail or Fax

Automatic Asset Reallocation Form

Use this form to authorize reallocating the separate account values to a specific percentage that you select for each Investment Division on either a quarterly, semi-annual, or annual basis.

Call Us: 1-800-225-5695

Mail or Fax

Change of Premium / Expense Allocation & Funds Transfer Form

Use this form to: a) Change how future premiums are applied. b) Select or Change how expense charges are deducted. c) Transfer funds from one Investment Division and/or Fixed Account to another.

Call Us: 1-800-225-5695

Mail or Fax

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.

Call Us: 1-800-225-5695

Mail or Fax

Dollar Cost Averaging Form

Use this form to establish DCA on a policy and/or make a change to an existing DCA arrangement.

Call Us: 1-800-225-5695

Mail or Fax

Interest Sweep Form

Use this form to elect the Interest Sweep option. This option provides for the interest earned on monies allocated to the Fixed Account to be transferred from the Fixed Account to any combination of Investment Divisions.

Call Us: 1-800-225-5695

Mail or Fax

Name Change Request Form

Use this form to process a change of Name on your policy.

Call Us: 1-800-225-5695

Mail or Fax

IRS Form W-4P - Withholding Certificate for Pension or Annuity Payments

Use this form for all annuity contract death claims.

Mail or Fax

IRS Form W-9 - Request for Taxpayer Identification Number and Certification

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.

Mail or Fax

Instructions for the Requester of Form W-9

Instructions to complete the IRS Form W-9.

Mail or Fax

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

Use this form if the beneficiary for a death claim is a non U.S. citizen residing abroad.

Mail or Fax

Telephone Authorization Form

Use this form to initiate telephone authorization to access information and/or process transactions over the telephone.

Call Us: 1-800-225-5695

Mail or Fax

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