Manhattan Insurance group



Life Forms

Claim Forms
Beneficiary Claimant Statement Gold Cross Burial Association Claim Form Premium Waiver Form
Other Forms
Affidavit of Lost Policy Form Affidavit of Lost Policy - International Life Policies Annuity Cash Value and Maturity Value Request Bank Draft Authorization Form (In English) / (en Español ) Beneficiary Change Form Cash Surrender or Partial Withdrawal Form Certificate of Trust Agreement Collateral Assignment HIPAA Form (release PHI from provider) / Agent HIPAA Form (release PHI to agent) / Family HIPAA Form (release PHI to Family Member/Other 3rd Party) Mortgage Company Release Authorization One and the Same Name Affidavit Ownership Change Form Policy Service Form

Life Forms