U.S. Financial Life Insurance Company

A Heritage Life Company

Customer forms

Contact information

1.  Assignment of policy as collateral security

2.  Electronic payment authorization

3.  Policy change

4.  Term re-entry

5.  Questionnaires

6.  W-9 request for tax payer ID

7.  Reinstatement forms

8.  HIPPA form

9.  Financial supplement

10.  Designation Identification Form

 

11.  Policy owner service request

     11a.  Address change

     11b.  Name or date of birth change

     11c.  Premium and mode change

     11d.  Loan request

     11e.  Full or partial surrender

12.  Beneficiary statement

13.  ACH authorization for direct deposit

14.  Beneficiary change

15.  Rights change

16.  Agent of record change

17. First notice of death

18.  Illustration request

19.  Request for term policy conversion