Manage policies

Use your life insurance policy as collateral

Instructions

Use your life insurance policy as collateral with this form.

  1. Complete form
    Provide information according to the instructions on the form.
  2. Requirements
    Complete the insured name, policy number, owner's signature, address and date. The request must contain the assignee's name, address, loan number and amount of the loan.
  3. Signatures
    Signatures must be witnessed or notarized and signed within 30 days of receipt. The form must also contain original signatures.
  4. Changes involving a corporation
    Corporate changes require the signatures of two corporate officers along with their titles.
  5. Power of attorney
    Requests from a power of attorney (POA) require that F&G have current (less than 6 months) POA documentation.
  6. Submit form
    Return the completed forms with any required documentation via U.S. mail, overnight mail or fax to our 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
    Allow 3 business days for faxed documents to enter our processing system.
  7. Confirmation
    A confirmation of this change will be mailed to the owner's address on record upon completion.
admin 5519
Assignment of Insurance Policy as Collateral
[ADMIN 5519]
Download form
22-0084