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- Click ‘Get Form’ to open it in the editor.
- Begin by completing the required fields, including your name, address, and policy information. Ensure all details are accurate for a smooth processing.
- Select your preferred withdrawal day from the options provided (1st through 28th). If no date is chosen, it will default to the monthly premium due date.
- Choose the frequency of payment: Monthly, Quarterly, Semiannually, or Annually. Be aware that some contracts may not allow all payment modes.
- Attach a voided check as instructed. This is crucial for setting up electronic transfers; ensure it is clearly marked 'VOID'.
- Review your entries for accuracy and completeness before submitting the form either by returning it to the company or faxing it to Premium Administration at 1-800-757-6324.
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