Transamerica Life Insurance Claims Address – 4333 Edgewood Road N*E* Cedar Rapids IA 52499-0001 Beneficiary Designation Form FAX 800-235-4782 Name S. address starting with the owner, unless otherwise specified below. ADDRESS NAME OWNER’S NAME CITY STATE ZIP GENERAL AGENCY/GA CODE REFER VERIFICATION FAX TO REQUIRE A NEW ADDRESS UPDATE* CHECK ABOVE NUMBERS. please look at me…
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Transamerica Life Insurance Claims Address
Allows you to make changes to your documents in just a few clicks. To edit Transamerica PDF exchange forms online for free, follow these steps:
Transamerica Life Insurance, Monumental Life Insurance
We have answers to our customers’ most popular questions. If you cannot find an answer to your question, please contact us.
You can change your life insurance beneficiary by contacting your insurance company. You must submit the Benefit Change Form online, in writing, or by phone.
You can usually check and update your list of beneficiaries by contacting the company or companies that provide your insurance or retirement plan. Sometimes you can do it online. Otherwise, you must fill out and sign the form before sending it.
Beneficiaries may be revocable or non-revocable. Beneficiaries can change at any time. Once named, beneficiaries cannot be changed without consent. You can designate as many beneficiaries as you like, subject to the conditions set out in the policy.
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Use this form to update the beneficiary information for your Traditional IRA, Roth IRA, Rollover IRA, SEP IRA, SIMPLE IRA, or 403(b) account.
7:26 9:59 How to fill out the Beneficiary Change Form – YouTube YouTube Start of offer clip End of offer clip However, please contact the Office of Pensions and Benefits for more information. You should contact the Office of Pensions and Benefits after receiving your type and for your best efforts. Form After filling out this section, all that remains is to enter your name and date. A model is selected. space.
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If the amount withheld per quarter is less than 500, apply for a refund on this report at the time of payment * If the withheld amount is…
Term Life Insurance
Beneficiaries can change at any time. Once named, beneficiaries cannot be changed without consent. You can designate as many beneficiaries as you like, subject to the conditions set out in the policy. The beneficiaries whose money goes in first are called first.
If you are specifying only one beneficiary, enter 100% in the Percentage column. If you nominate more than one beneficiary, you must indicate the percentage each beneficiary will receive.
In most cases, it is easy to change the beneficiary of a life insurance policy. All you have to do is contact your insurance agent to request changes to your benefit document and fill out the form accurately and completely.1 All fields must be completed. Application Contact Transamerica Life Insurance Company Partner: Munich Print or enter personal information for Re Stop Loss, Inc. Full Name First Name Middle Last Name Previous Address (if under 5 years old) Home Phone Number ( ) Social Security Number Date of Birth / / Male Spouse Marital Status Company Name Company Name Mailing Address Company Number ( ) Fax Number ( ) Address Current NALU Member Yes No Registered NASD Business Year Registered Yes No If yes, NASD Series No Annuity Variable Annuity State of Residence: License Number: License Type: (include license) List non-resident states in which you currently license and wish to be elected (include license for each state) Current Agreement List of companies in progress. Name E&O Carrier E&O Policy Number Let Company Pay For: Individual Company (including company policy if applicable) Company Name Tax Number (Rev. 1/2005) 1/5
2 If you answered yes to any of the following questions, please provide detailed information on a separate sheet of paper. Failure to provide sufficient information in the correct format will result in delay or denial of notice. Have you currently been charged, pleaded not guilty, or have you ever been convicted of a crime (other than a minor traffic offense)? Are you currently or have you ever been the subject of any lawsuit, claim, investigation or proceeding alleging a breach of trust or fiduciary duty, falsehood, fraud or dishonesty? Is the agent’s license or registration suspended or revoked, or is the subject of, or pending, a current or licensure/registration or marketing investigation, representation? Have you ever been unfairly dismissed for default or allowed to quit your job as an agent or appointed agent for an insurance or other financial institution? Has a bond, insurance, or E&O provider ever denied your application, billed you, billed you, or terminated your insurance? Are you delinquent on personal or commercial financial services or financial institution insurance that pays for direct debit payments? Are there outstanding judgments, debts or claims against you, including unpaid taxes? Cash Withdrawal Date Have you ever owned a business under another name? In the past 10 years, have you or the business in which you are an owner, partner, employee or director engaged in any legal, civil or criminal activity not identified above? Yes No Employment History List the insurance companies you have worked with or contracted with in the past 5 years. If your experience is less than 5 years, please include the last 10 years. Sender Business Address (City and State) Phone Number Let Us Contact You Correct Credit Reporting Policy/Consumer Rights I authorize and request current or former employees, police departments, financial institutions, insurance companies, insurance departments, or other parties. To provide the insurance company with information about me and any information they have about me in connection with the application for appointment of an insurance agent. I agree that this photograph may be authorized under the same permission as the original, and upon request release any written information created by current or former employees to provide information. I have given the sole notice to the customer that the report may be requested and used for investigation to appoint an insurance agent. I acknowledge that I am aware of the insurance and safety regulations (if applicable) and the eligibility regulations for which I am applying. I understand and agree that I am not authorized and that I am prohibited from soliciting business until approved. I certify under penalty of perjury that the social security number or taxpayer identification number displayed on this form is my correct taxpayer identification number and is not authorized for withholding by the Internal Revenue Service. The undersigned acknowledges receipt of the Professional Code of Conduct. Registrants further acknowledge that they have reviewed the Code of Professional Conduct. The registrant is responsible for conducting insurance business on behalf of Transamerica Life Insurance Company in cooperation with the law firm of AEGON, USA, Inc. We have the highest standards of honesty and integrity. The business practices of these companies must follow the Code of Professional Conduct and the Marketplace Standards Association. I agree that my current responsibilities include adhering to the following Code of Professional Conduct: You are responsible for dealing on behalf of the company in accordance with a code of professional conduct that has been submitted to the company and is compatible with insurance. Marketplace Association’s Principles and Code of Conduct. In connection with the marketing of Transamerica Life Insurance Company products and Transamerica Life Insurance Company customer services, I will comply with all applicable laws and regulations requiring privacy of non-public personal information about applicants or persons eligible for insurance. In relation to policyholders, insured persons, beneficiaries or other customers, I will not disclose or use any information provided by Transamerica Life Insurance Company I except as necessary to accomplish the purpose for which it was provided. Signature Date of issue (Rev. 1/2005) 2/5
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3 Customer Notice We inform you that customer reports or customer reviews may be obtained from the customer service department for the purpose of evaluating customers.
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