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Americo Forms

Use the following forms to make simple changes to your policy or annuity contract. For more information about making changes to your policy, visit the Frequently Asked Questions section for Policyholders or call us at 800.231.0801.

Completed forms can be sent to the email, fax number, or mailing address below.

submit@americo.com

800.395.9238 (fax)

Americo Financial Life and Annuity Insurance Company
PO BOX 410288
Kansas City, MO, 64141-0288

 

Beneficiary Change Request Form

To change the current designation on your policy, use the
Individually Owned or Multiple Persons Owned Policies form.

If your policy is a 403b Tax Sheltered Annuity or currently owned by a pension
trust that wil require the signature(s)and title(s) of the trustee(s), use the
Qualified Retirement Plan form.

If your policy is owned by a corporation or partnership that requires the
signatures and titles of two officers or two partners, use the
Corporation Owned form.

If your policy is currently owned by a trust requiring the signature(s) and title(s)
of the trustee(s), use the Trust Owned form.

Ownership Change Request Forms

To designate a new owner(s) for your policy, use the
Individually Owned or Multiple Persons Owned Policies form.

If a corporation currently owns your policy, the signatures and titles of two
officers are required, use the Corporation Owned form.

If your policy is currently owned by a trust requiring the signatures and titles of
the trustees, use the Trust Owned form.

Address Change Request Form

It is very important that we have your up-to-date contact information on file. If your address changes, please complete the Change of Address Notification or contact us with your new information.

Annuity Withdrawal Form

To withdraw funds from your non-qualified annuity, use this Annuity Withdrawal form.
To withdraw funds from your qualified annuity use this Annuity Withdraw form.

Annuitant Change Request Form

Use the Annuitant Change Request form to change the Annuitant (person receiving funds distributed from the annuity).

Bank Draft Authorization Form

To authorize Americo to make withdrawals from your account for payments, please fill out the Bank Draft Authorization form.

Collateral Assignment of Policy/Release of Assignment of Insurance Policy Form

If you are using your insurance as collateral, use the Collateral Assignment form.

Name Change Request Form

It is important for us to know if your name has changed. Use the Name Change Request form to let us know.

Payroll Deduction Change Authorization Form

If you have payroll deductions automatically contributed to your qualified Tax-Sheltered Life, Annuity, or Custodial Account for Regulated Investment Company Stock, fill out the Payroll Deduction form and provide it to your employer.

Required Minimum Distribution Election Form

If you wish to begin receiving the required minimum distribution as set forth by the Internal Revenue Code fill out the Distribution Election form.

Universal Life Partial Surrender Form

To request a partial surrender from the cash value of your universal life insurance policy, use the Partial Surrender form.

W-9 Request for Taxpayer Identification Number and Clarification

If you are required to file an information return with the IRS that requires you obtain your correct taxpayer identification number (TIN) to report, use the W-9 Request form.