Manage Policies

Authorize or change automatic premium bank information

Instructions

Authorize electronic drafts easily with this form.

  1. Complete the financial institution section
    Complete this section of the form with the following:
    • Name of institution
    • Type of account
    • Routing number
    • Account number
    • Policy number
  2.  
  3. Sign the signature section
    Complete the signature section with account holder and policy owner printed name, signature and date.
  4.   
  5. Submit form
    Return the completed forms with any required documentation via postal mail, overnight mail or fax to F&G Service Center.

    Postal Mail
    F&G Service Center
    P.O. Box 81497
    Lincoln, NE 68501-1497

    Overnight Mail
    F&G Service Center
    777 Research Drive
    Lincoln, NE 68521

    Fax
    800.281.5777
  6.  
  7. Allow 15 days to process
    F&G will process the request within 15 business days of receipt if in good order.
  8.  
  9. Confirm updates
    We will mail a confirmation letter that the request was processed to the owner's address on record.
  10.  
admin 5778
Pre-Authorized Check (PAC) Authorization Form
[admin 5778]
Download Form
18-1259