Resources
Administrative Office Employee Extensions (PDF)
Claims
Form 46C (PDF)
Claim Form
AL CL-1011 Aff of Kin (PDF)
CL-1012 Aff of CD (PDF)
Misc. Forms
21001 (08-2009) Reinstatement Form (PDF)
PAT (PDF)
Policy Service Forms
Age Correction (PDF)
Beneficiary Change (PDF)
Cancel - no cash value Form 38NCV (PDF)
Cash Surrender Form (PDF)
Change Premium Mode (PDF)
Lost Policy Affidavit - Form 6 (PDF)
Name Change (PDF)
Change in Premium Payor (PDF)
Change Owner (PDF)
Deceased Owner - No Estate (PDF)
Policy Loan Agreement Form 52 (PDF)
Reduced Paid Up Option - Form 75 RPU (PDF)
UND - NE State Approved
80296 Financial Questionnaire (PDF)
80301 - Paramed Exam (PDF)
Aviation Questionnaire (PDF)
Avocation Questionnaire (PDF)
DAQ-Drug Alcohol Questionnaire (PDF)
Foreign Travel Questionnaire - UND-251 (PDF)
Military Questionnaire (PDF)
Notice and Consent Form for AIDS Virus (PDF)
R2501-Replacement Form (PDF)