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Surrender-Cancellation Statement - American Fidelity

Surrender-Cancellation Statement - American Fidelity 2026

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The document outlines the signature requirements and procedures for policy changes, cancellations, or surrenders related to life insurance policies issued by American Fidelity Assurance Company. It specifies the necessary signatures and supporting documents needed based on the type of policyowner (individual, partnership, corporation, or trust) and includes a surrender/cancellation statement for policyowners to complete.

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Click ‘Get Form’ to open the Surrender-Cancellation Statement in the editor.
Begin by entering your policy number in the designated field. This is crucial for identifying your specific policy.
Fill in the insured's name and address details accurately to ensure proper processing of your request.
As the policyowner, provide your full name, address, and social security number. If there are multiple owners, all must sign.
In the surrender statement section, confirm your intention to cancel the policy by signing and dating where indicated.
If applicable, initial next to the appropriate statement regarding the original policy's status (lost or destroyed).
Review all signature requirements based on your ownership type (individual, partnership, corporation, or trust) before submitting.

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Versions	Form popularity	Fillable & printable
2017	4.9 Satisfied (46 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can you cancel American Fidelity insurance?

The Owner must submit a written request of cancellation referencing policy number, signature, social security number, and address.

Is American Fidelity a good insurance company?

What is a pre-existing condition? A condition for which you have received treatment, incurred expense, taken medication, received services or a diagnosis or advice from a physician during the period described in the policy immediately before the effective date of coverage.

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