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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2016 | 4.2 Satisfied (49 Votes) |
The form allows policyowners to designate a third-party individual to be notified if their insurance policy is at risk of lapsing.
The designated third-party will only receive notifications regarding the policy status and no other personal information will be shared.
Both the policyowner and the third-party designee must sign Section A when adding or updating a designee, while either party must sign Section B when removing a designee.
The form can be used not only to add a new designee but also to update the address of an existing designee.
Policyowners can choose to remove all third-party designees or specify one particular designee for removal.
If signing in a fiduciary capacity, relevant legal documentation must be attached if not already on file.
