Generic Life Insurance Assignment Form

General what is an assignment.

Generic life insurance assignment form. Complete either assignment type a b or c. Description assignment insurance funeral. A statement of charges for funeral. And i hereby authorize and direct said insurance company to make its check payable to said funeral director for the assigned amount and to pay the remainder of the proceeds of said insurance policy if any to me.

Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction. This form is a generic example that may be referred to when preparing such a form for your particular state. First name middle name last name relationship to insured social security number date of birth. Mm dd yyyy if not equal permanent address city state zip country of citizenship phone number first name middle name last name.

A sample legal form template for assignment of life insurance. An assignment of life insurance is the transfer of. An assignment is irrevocable and cannot be changed later. 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.

It is for illustrative purposes only. Do not use this form if you only wish to designate a beneficiary to receive your life insurance. Out of the proceeds of said insurance policy. The assignee is the person s firm s or trust s usually named on an assignment form ri 76 10 who owns and controls the insured s life insurance coverage.

Assignment to one or more individuals.