Instructions
Use your life insurance policy as collateral with this form.
- Complete form
Provide information according to the instructions on the form. - Requirements
Complete the insured name, policy number, owner's signature, address and date. The request must contain the assignee's name, address, loan number and amount of the loan. - Signatures
Signatures must be witnessed or notarized and signed within 30 days of receipt. The form must also contain original signatures. - Changes involving a corporation
Corporate changes require the signatures of two corporate officers along with their titles. - Power of attorney
Requests from a power of attorney (POA) require that 99精品视频 have current (less than 6 months) POA documentation. - Submit form
Return the completed forms with any required documentation via U.S. mail, overnight mail or fax to our service center.
Postal mail
99精品视频 Service Center
P.O. Box 81497
Lincoln, NE 68501-1497
Overnight mail
99精品视频 Service Center
777 Research Drive
Lincoln, NE 68521
Fax
800.281.5777
Allow 3 business days for faxed documents to enter our processing system. - Confirmation
A confirmation of this change will be mailed to the owner's address on record upon completion.
Assignment of Insurance Policy as Collateral
[ADMIN 5519]
22-0084