Online Financial forms at your fingertips
The States Below are available to check on Advisors or Agents License Standings By CLICKING HERE
US Virgin Islands, Vermont, West Virginia, Wisconsin
The States Below are available to check on State Websites- for Advisors or Agents License Standings By clicking the state in question:
California - Colorado - Florida - Georgia - Indiana - Kentucky - Louisiana - Maine - Michigan -
Minnesota - Mississippi - New York - Nevada - Ohio - Pennsylvania - South Dakota - Texas -
Utah - Virginia - Washington - Wyoming
Change a beneficiary designation – Complete the Beneficiary Change/Designation section on Page 1 and the Signature section on Page 2. Qualifying witnesses include any adult other than the insured, designated beneficiary or policyowner.
Policy Service Form (All states except CA)
Change mailing address – Complete the Change of Mailing Address section on Page 1 and the Signature section on Page 2.
Policy Service Form (All states except CA)
Change or correct name of insured or owner – Complete the Name Change/Correction and Signature sections on Page 2 along with the included W-9 for the individual whose name is being changed/corrected.
Policy Service Form with W-9 Taxpayer ID Certification (All states except CA)
Policy Service Form with W-9 Taxpayer ID Certification (CA)
Change an ownership designation – Complete the Ownership Designation section on Page 1 and Signature sections on Page 2 along with the included W-9 for the new owner(s).
Policy Service Form with W-9 Taxpayer ID Certification (All states except CA)
Request a loan, partial withdrawal or surrender on your LIFE insurance policy:
Policy Service Form with W-9 Taxpayer ID Certification (All states except CA)
Policy Service Form with W-9 Taxpayer ID Certification (CA) - Complete the service form indicating the desired transaction. The policyowner must sign and date the service form and the included W-9.
Electronic Funds Transfer - Use to request deposit directly into savings or checking account.
Request a partial withdrawal, distribution or surrender from your ANNUITY contract:
Annuity Service Form with W-9 Taxpayer ID Certification (All states except ME)
Annuity Service Form with W-9 Taxpayer ID Certification (ME) - Complete Page 2 and the Signature section on Page 3 along with the W-9 for policyowner requesting the transaction.
Electronic Funds Transfer - Use to request deposit directly into savings or checking account
Request annuitization/settlement option on your ANNUITY contract:
Annuity Service Form with W-9 Taxpayer ID Certification (All states except ME)
Annuity Service Form with W-9 Taxpayer ID Certification (ME) - Complete Page 1 and the Signature section on Page 3 along with a W-9 for policyowner requesting annuitization/settlement option.
Electronic Funds Transfer - Use to request deposit directly into savings or checking account.
Pre-Authorized Withdrawal Agreement – Complete, sign, and date the form.
Remove a rider – Complete Change Base Policy section on Page 1 indicating which rider is to be removed and complete the Signature section on Page 2.
Policy Change Form (All states except CA)
Add a child to an existing Children's Term Rider – Complete the Addition of Child to Existing Children's Term Rider and Signature sections on Page 2.
Policy Service Form (All states except CA)
Review the Life Insurance Buyer’s Guide – Learn how to find a policy that meets your needs and fits your budget, decide how much insurance you need and make an informed decision when buying a policy.
Life Insurance Buyer's Guide (All states except ME, NJ)
Life Insurance Buyer's Guide (ME)Life Insurance Buyer's Guide (NJ)
Review the Annuity Buyer’s Guide – Understand the differences among various annuities so you can choose the kind that best fits your needs.
Buyer's Guide to Fixed Deferred Annuities (All states except MT, NM)
Buyer's Guide to Fixed Deferred Annuities (MT, NM)
Report a Life, Annuity or Disability Claim – Life Claims Process - Download the necessary forms, find contact information and learn what to expect during the process.
Signed Forms
Return completed, signed forms to Ai Merchantry.
Mail:
Financial / Policy Services
Americas insurance Merchantry™
207 W Millbrook Road, Suite 200
Raleigh, NC 27609
Fax:
1-844-626-2246
Email:
[email protected]
Helping you achieve financial success with expert guidance and personalized strategies.
Corporate Office:
207 W. Millbrook Road, Suite 200
Raleigh, North Carolina 27609
(844) 626-2246
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