Life Insurance Claim Form Please complete, sign and return this form to start the claim process 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'About You' section. Provide your full name, contact information, relationship to the deceased, and Social Security number. Ensure all details are accurate for prompt processing.
3. Next, complete the 'About the Deceased' section. Enter the deceased's name, date of birth, date of death, and Social Security number.
4. Proceed to the 'Tax Certification' section. Indicate if you are subject to backup withholding or FATCA reporting by checking the appropriate boxes.
5. In the 'How to Receive Your Funds' section, select your preferred payment option: Alliance Account or lump sum check. Review details about each option carefully.
6. Sign and date the form in the 'Signature' section. Make sure you understand any fraud warnings included.
7. Finally, return the completed form along with any required documentation (like a death certificate) via mail or fax as instructed.

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