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Assignment of Life Insurance
WARNING! This form permanently transfers ownership of your FEGLI insurance to another individual, trustee, or corporation (however, premiums continue to be withheld from your salary/annuity). An assignment is irrevocable, and cannot be changed later. DO NOT USE THIS FORM if you only wish to designate a beneficiary to receive your life insurance. Instead, use the available designation of beneficiary form .
For more information about assignments and designations of beneficiary, see the FEGLI Booklet on Assignments , and Designation of Beneficiary and Order of Precedence .
FEGLI enrollees use this form to assign ownership of their life insurance coverage to another person, firm, or trust; and assignees use the form to reassign the coverage.
Electronic Copies:
RI 76-10
Paper Copies:
Request a paper copy of this form from your servicing Human Resources Office.
Annuitants:
- Call toll free 1-888-767-6738 (202-606-0500 in the DC Area), or
- Send an email to [email protected] , giving the number of the form that you need and your mailing address, or
- Request a copy from a local Federal agency Human Resources Office.
IMAGES
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COMMENTS
American General Life Insurance Company. The United States Life Insurance Company in the City of New York. A member of American International Group, Inc. (AIG) A. It is expressly agreed that, without detracting from the generality of the foregoing, the following specific rights are included in this assignment and pass by virtue hereof: 1.
If you are not a U.S. person, you are required to submit the applicable IRS Form W-8 series (BEN, BEN-E, ECI, EXP or IMY). Under penalties of perjury, I certify to the following: That the taxpayer identification number listed on this form is my correct SSN/TIN and I am a U.S. Citizen or other U.S. person (including resident aliens);
collateral assignment not disclosed above divorce or separation agreement attachments irrevocable beneficiary arrangement any legal action tax lien insolvency proceedings Page 1 of 2 AGLC109155 Rev0822 6.
Section E - Irrevocable Beneficiary/Assignee Signature and Date (if required) TAX CERTIFICATION (Substitute Form W-9) - Applicable to U.S. persons (including U.S. citizens and resident aliens). If you are not a U.S. person, you are required to submit the applicable IRS Form W-8 series (BEN, BEN-E, ECI, EXP or IMY).
American General Life Insurance Company (AGL), Fixed Life Service Center - P. O. Box 4373, Houston, TX 77210-4373 Variable Life Service Center - P. O. Box 4880, Houston, TX 77210-4880 Member of American International Group, Inc. Instructions for completing this form are listed on the back. CONTRACT IDENTIFICATION.
For value received and hereby acknowledged, I hereby transfer, assign, and convey absolutely to the "New Owner" all incidents of ownership and control, and all right, title and interest in and to the policy numbers reference above (including all Supplementary Agreements or Riders attached thereto).
Change Common forms Can't Find What You're Looking For? Contact the American General Customer Support Team at one of the options below: 800-888-2452 eService Need a Quote for Life Insurance? Get a quote Recently Married? New Family Member? Bought a New Home?
For overnight mail, some older forms may list "AIG - Production #2" in the first line of the mailing address. Using either option is acceptable for mailing purposes. Fax. 855-601-1834. Variable Universal Life (VUL) Policies. U.S. Mail. American General Life Insurance Company P.O. Box 818016 Cleveland, OH 44181. Overnight Mail
Please scan and return your completed, signed form to us by: ¾ Email: [email protected] ¾ Fax: 1-605-719-0601 You will receive confirmation once we've completed processing your request. If you have any questions, please feel free to contact us at 1-800-533-2220. American Memorial Life Insurance Company P.O. Box 2730 Rapid City, SD 57709
An assignment is irrevocable, and cannot be changed later. DO NOT USE THIS FORM if you only wish to designate a beneficiary to receive your life insurance. Instead, use the available designation of beneficiary form.
The assignment form must include the policy number(s), the dollar amount you wish to assign and the signature of the beneficiary. If you need assistance completing this form, please contact us toll-free at 1-800-888-2452. MIB PRE-NOTICE Information regarding your insurability will be treated as confidential. American General Life and Accident ...
To assign a certificate, this form needs to be signed, dated, properly notarized and submitted to our headquarters. Applicant change form An applicant is the owner of a certificate in which the insured was 15 years old or younger at the time of the original issue. This form allows for the current applicant to be changed to another individual.
Term Life Insurance can help your loved ones with: Mortgage Payments. College Tuition. Debt/Credit. Monthly Income. You Started a Family. You Bought a Home. Your Income Changed. Your Health Changed.
Collateral Assignment of Policy 18-236-1 (09/18) Americo Financial Life and Annuity Insurance Company Phone: 800.231.0801 • Fax: 800.395.9238 • Email: [email protected]
American General Life Insurance Company The United States Life Insurance Company in the City of New York A member of American International Group, Inc. (AIG) A. It is expressly agreed that, without detracting from the generality of the foregoing, the following specific rights are included in this assignment and pass by virtue hereof: 1.
INSTRUCTIONS • Use this assignment of compensation form (the "Assignment") to assign your commissions • Complete Sections I-IV.Section V is for home office use only. • Be sure to sign and date the form.Original signatures required (and title, if other than individual). • Assignee must be licensed and appointed if involved with the sale of the policy generating the assigned commissions.
Policy Loan Application. In this form, the "Company" refers to the insurance company whose name is checked above. The Company shown above is solely responsible for the obligation and payment of benefits under any policy that it may issue. No other Company is responsible for such obligations or payments. Mailing Instructions: Send form(s) to ...
This Assignment shall apply to and be effective under any Policy issued by the Company in exchange for the Policy or as a renewal or conversion thereof. L. The validity of this Assignment is hereby guaranteed by each of the undersigned. M. For administration of the Policy by the Company, the effective date of this Assignment shall be the same ...
General Life Insurance Company is not affiliated with New York Life Insurance Company. SMRU# 1900746 - (Expires 5.18.23) How are funeral assignments handled? ACTION CLARIFICATION What is a Funeral Assignment? beneficiary of a life insurance policy. The beneficiary assigns all or a Does New York Life Group Benefit Solutions (NYL GBS) accept ...
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