Assignment Form
Use the Assignment Form if you would like to change the ownership of your existing account that you have on file with the Plan Agent. If you wish to only change your name or beneficiary currently filed with the Plan Agent, please complete a Change of Name/Beneficiary Form.
Click here to complete an on-line Assignment Form to be printed, signed and mailed.
Note: When completing this form on-line, you will need to have the following information: Name, Social Security Number and Account Number of the Insured along with the Name and Address of the Assignee.
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Click here to download and print a blank Assignment Form as a PDF file.
