North American Company Life Forms. Available for PC, iOS and Android. 0ed81304-74f8-4d32-947d-3c9d8d794c9d. Minnesota Life Insurance Company. 1776 AMERICAN HERITAGE LIFE DRIVE JACKSONVILLE, FLORIDA 32224-6688 (904) 992-1776 CHANGE OF BENEFICIARY REQUEST To be attached to Policy No. The American Heritage Life Insurance Company (hereinafter called the Company) is hereby requested to revoke all prior American Equity's Customer Service Forms . # Annuitant City Owner State Zip Change Address Change of Ownership - AGLC0013. Read instructions on the Back of Part 2 before completing this form. Change of Beneficiary. American General Life Insurance Company. Life insurance change of Beneficiary - Short form . The required form of proof will be indicated in the claims packet sent to the beneficiary. Corporate Headquarters Great American Insurance Group Tower 301 E. Fourth St. Cincinnati, Ohio 45202 800-545-4269 / 513-369-5000 Beneficiary Change Form. Change of Beneficiary - AGLC101311. 3206-0136 Federal Employees Federal Employees' Group Life Insurance (FEGLI) Program Important: Group Life Insurance (DO NOT erase or cross-out. Beneficiary Designation Securian Life Insurance Company. The document required varies depending on the dollar amount of the benefit payment or circumstances of death, see table below. Fill out, securely sign, print or email your north american company for life and health insurance change of beneficiary form instantly with SignNow. Metropolitan Life Insurance Company Metropolitan Tower Life Insurance Company. AFG is a Fortune 500 holding company whose common stock is listed on the New York Stock Exchange. Form Approved Designation of Beneficiary OMB No. © 2017 Standard Life and Accident Insurance Company, Galveston, Texas.. Application for Accident Insurance - AGLC101724-WA [WA] Application for Reinstatement or Reduction of Premium - AGLC100440-33 [NY] Assignment - AGLC0205 [Generic] Change of Beneficiary - AGLC0108. Group Customer Service • 400 Robert Street North, St. Paul, MN 55101-2098. North American Company for Life and Health Insurance Annuity Service Center P. O. Things to know before you begin Great American Insurance Group’s member companies are subsidiaries of American Financial Group, Inc. (AFG). The United States Life Insurance Company in the City of New York. _____on the life of _____. Use this form to change the Beneficiary where the Owner is the Insured and the new Beneficiary is an individual. The Company … A member of American International Group, Inc. (AIG) In this form, the “Company” refers to the insurance company whose name is checked above. Note: Only one proof of death is required for the deceased, even when there are multiple claimants and/or policies. Box 79905 • Des Moines, Iowa 50325-0905 Service Request Please Print I hereby request and direct the Company to change this contract as follows: Annuitant/Insured Owner Contract Number Street Apt. Not connected with or endorsed by the U.S. Government or the Federal Medicare Program. We thank you for your business. American Equity is committed to excellent customer service and provides our clients and agents easy access to preview, download, or email the necessary forms for your annuity contract needs. This form authorizes American Family Life Insurance Company to receive health information related to a rate reconsideration or a reinstatement of a life insurance policy. The most secure digital platform to get legally binding, electronically signed documents in just a few seconds. Fax 651-665-4827 • Completing this Beneficiary Designation form will revoke all current beneficiary designations. This form is used to change, update or add beneficiaries to a policy. 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