Verification Request Form

Americo verification request form for use by funding companies or funeral homes.

"*" indicates required fields

Deceased Date of Birth*
Disclaimer*
Drop files here or
Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 15 MB, Max. files: 5.
    An assignment form, signed by the beneficiary or beneficiaries is required. Please note that this is for verifications only. If you are submitting claimant statements, death certificate, or other documents, upload on our claims homepage or send to forms@americo.com
    This field is for validation purposes and should be left unchanged.