Annuity
Commercial Loans
General Policy Holder Service
Life Insurance (Individual, Group & Payroll Deduction)
Funeral Insurance Forms

To view and print forms, you will need Adobe® Acrobat® Reader. If you do not already have Adobe Acrobat on your computer, click here to download it for free. Warning: some pdf files are large and could take several minutes to download from slower Internet connections.



General Policy Holder Service Forms
Policyowner Service
Death Claim Form
Release of Beneficiary
Electronic Premium Payment Authorization
Replacement of Life Insurance

Annuity Forms
Application
Trustee to Trustee Transfer (Incoming Rollovers)

Life Insurance Forms
Individual
Life Application
One Step Application
First Steps Application
Death Claim Form
Loan Protector Application (Indiana)
Loan Protector Application (Wisconsin)

Group & Payroll Deduction
Dental
Employer Application Form
Employee Enrollment Form
Dental Claim Form

Medi-Gap
Medi-Gap Rates
Medi-Gap Application (Indiana)
Medi-Gap Application (Wisconsin)
Death Claim Form

VIP Plans
Worksite Deduction Application
VIP Capitalize on Your Future
VIP Accidental Death
VIP Cancer Coverage
VIP Family Term Rider
VIP Short Term Disability Rider
VIP Short Term Disability Stand Alone
VIP Term Life

Death Claim Form
Short Term Disability Claim Form

Funeral Insurance Forms

Pre-Need Quickstart Instructions Application Rate Card Irrevocable Funeral Trust Agreement At-Need Death Claim Form

Key Life forms Irrevocable Assignment of Ownership Payment Authorization Death Claim Form American Memorial At-Need Death Claim Form Investors Heritage Pre-Need Quickstart Instructions Guaranteed & Simplified Issue Rate Card Revocable Assignment of Proceeds Irrevocable Assignment of Ownership At Need Death Claim Form - Funeral Director's Statement (For use by Funeral Directors licensed with Investors Heritage) Death Claim Form - Claimant's Statement (For policies within the contestable period) Dispute Resolution Payment Authorization

1500 Plan Commissionable Whole Life Insurance Pre-Need Quickstart Instructions Application Rate Card Funeral Service Agreement Irrevocable Assignment Ownership Assignment of Proceeds Suitability Disclosure Agent Recitals At Need Death Claim Form Non-Commissionable Whole Life Insurance Pre-Need Quickstart Instructions Application Assignment At Need Death Claim Form

Commercial Loan Forms
Commercial Loan Application
Loan Commitment Offer

Please call for currents rates at 317-231-2700 or 800-323-0995.