Download and print the form you need, then mail the completed form to us. Click a form category to show only those forms. If the form you need isn't available below, please contact us.
Change of Beneficiary Form - Form #13977
Use the change of beneficiary form to change a primary or contingent beneficiary designation.
Additional Beneficiaries Designation Supplement to Beneficiary Change Request - Form #17963
Use this form to elect Additional Beneficiaries for your contract(s), if you do not have enough space on Form 13977 (Beneficiary Change Request).
Change of Beneficiary for Indexed Survivorship Universal Life Supplemental Insured Rider Form
Use this form to change the beneficiaries for your Indexed Survivorship Universal Life (ISUL) Supplemental Insured Rider.
Trust Verification Form - Form #16541
Used by policy owners, in lieu of the complete copy of the trust, to certify the name, date and trustees of their trust.
Bank Authorization Form - Form #15036
To have your premium payments automatically deducted from your checking account, submit this form and a void check or Specification Sheet from your account. Please contact the Home Office at least ten days prior to your draft date for any changes to an existing Pre-Authorized Check agreement.
Policy Loan Request Form - Form #15035
Used by policy owners to request a loan from their life insurance policy.
Change of Ownership Form - Form #15028
Use this form to transfer the ownership of your policy.
Authorization to Release Information - Form #17624
Use this form to agree to an information release.
Address Change Request - Form #19400
Used by policy owners to notify us in the event of a change to the current address on file.
Name Change Request - Form #17884
Used by policy owners to notify us in the event of a legal name change.
Request for Co-Ownership - Form #16283
This form is to be utilized any time there will be more than one owner.
Pension Plan Verification - Form #17982
Use this form to verify your pension plan.
Collateral Assignment – Form #15038
Use this form to assign the rights and privileges of your policy to another person or entity.
Life Insurance Form Statement of Beneficiary for Accordia Life. - Form #17003
Life Insurance Form Statement of Beneficiary for First Allmerica Financial Life Insurance Company - Form #17003(FANY)
Arizona State-Specific Policy Application for Reinstatement - Form #175136
Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of Arizona.
California State-Specific Policy Application for Reinstatement – Form #11843CA
Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of California.
Connecticut State-Specific Policy Application for Reinstatement – Form #15006CT
Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of Connecticut.
Delaware, District of Columbia and South Dakota Multi-State Policy Application for Reinstatement – Form #18373
Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of Delaware, the District of Columbia or South Dakota.
Florida State-Specific Policy Application for Reinstatement – Form #11859FL
Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of Florida.
New Jersey State-Specific Policy Application for Reinstatement – Form #18950NJ
Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of New Jersey.
North Dakota State-Specific Policy Application for Reinstatement – Form #11894ND
Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of North Dakota.
Multi-State Policy Application for Reinstatement – Form #ICC-11802
Use the Application for Reinstatement to request a reinstatement of a lapsed policy. This version is for residents of states that do not require their own variation of the form.
Wellness for Life® Program Rewards Qualification Form - Form #16489
Used to stay qualified for the Wellness for Life® program. Complete the Wellness for Life® Program Qualification Form and have it signed by your doctor/health care provider at your regularly scheduled routine physical.