0001 800-222-2062 - nationalbenefitlife-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in the 'Insured' field with the name of the individual whose policy is being updated.
3. Enter the corresponding 'Policy Number(s)' associated with the insured individual.
4. Indicate whether you are changing the name of the Insured, Owner, Beneficiary, or Annuitant by checking the appropriate box.
5. In the 'From' section, write down the previous name as it appears on the policy. Then, provide your signature and print your name below.
6. In the 'To' section, enter the new name. Again, sign and print your name below this field.
7. Select a reason for the name change from options like Marriage, Court Order, Correction in Spelling, or Other. Provide details if necessary.
8. Complete additional information for the Insured/Owner/Beneficiary/Annuitant including current address and telephone number.
9. If known, include Social Security Number and Date of Birth in their respective fields.
10. Finally, date and sign at the bottom of the form to finalize your submission.

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