Form Number DescriptionType
Application Packets
U-664-FLTeleLife Fax Pre-Application Application Packets
ADMIN-2494214Electronic Policy Delivery FormApplication Packets
Riders/Benefits Forms
HHA-ECR-EmployerHold Harmless Agreement for Employer Owned Policy with ECRRiders/Benefits Forms
HHA-ECR-TrustHold Harmless Agreement for Trust Owned policy with ECRRiders/Benefits Forms
HHA-OneIns-MultECRHold Harmless Agreement-One Insured-Multiple Policies with ECRRiders/Benefits Forms
Conversion & Replacement Forms
A-1129-FLA (Life)Comparative Information Form For Proposed InsuranceConversion & Replacement Forms
A-1129-FLA (Ann)Comparative Information Form For Proposed InsuranceConversion & Replacement Forms
A-1128-FLA (Life)Notice to Applicant Regarding Replacement of Life Insurance (FL)Conversion & Replacement Forms
Miscellaneous
Pre-Application Fax Entry Instructions IADPre-Application Fax Entry ProcessMiscellaneous