Americo | Verification Request Form

Verification Request Form

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

"*" indicates required fields

Assignment Company/ Funeral Home Name*

Requester Name*

Assignment Company/ Funeral Home Phone Number*

Requester Email*

Policy Number*

Deceased Name*

Deceased Date of Birth*

Assignment Number*

Beneficiary Name*

Upload Assignment and Verification Request*

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: https://americo.com/claims/#contact-claims or send to forms@americo.com

Phone

This field is for validation purposes and should be left unchanged.

Verification Request Form

Existing Policies

Filing a Claim