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Policy Change Forms: Annuities

Request for Service Form Form # 57201
Aviva Life and Annuity Company (formerly American Investors Life Insurance Company, Inc.)
Transfer of ownership, name contingent owner, change of name, address change, or beneficiary change.

Download PDF (197 KB)

Request for Service Form Form # 13978
Aviva Life and Annuity Company
Use when customer requests systematic withdrawals, to name contingent owner, change of name, address change, or beneficiary change.

Download PDF (26 KB)

Transfer of Ownership Form Form # 13977
Aviva Life and Annuity Company
Use when customer requests a transfer of ownership.

Download PDF (19 KB)

Withdrawal or Surrender Form Form # 53069
Aviva Life and Annuity Company (formerly American Investors Life Insurance Company, Inc.)
Use to withdraw or surrender a single premium or flexible premium annuity.

Download PDF (23 KB)

Policy Change Forms: Life Insurance

Change of Beneficiary Form Form # 15029
Aviva Life and Annuity Company
Use the change of beneficiary form to change a primary or contingent beneficiary designation.

Download PDF (44 KB)

Change of Beneficiary Form Form # BL-088
Aviva Life and Annuity Company of New York
Use the change of beneficiary form to change a primary or contingent beneficiary designation.

Download PDF (45 KB)

Change of Name or Address Form Form # 15030
Aviva Life and Annuity Company
Used by policy owners to notify us in the event of a legal name change or to request a change to the current address on file.

Download PDF (40 KB)

Change of Name or Address Form Form # BL-089
Aviva Life and Annuity Company of New York
Used by policy owners to notify us in the event of a legal name change or to request a change to the current address on file.

Download PDF (42 KB)

Change of Ownership Form Form # 15028
Aviva Life and Annuity Company
Use this form to transfer the ownership of your policy.

Download PDF (42 KB)

Change of Ownership Form Form # BL-087
Aviva Life and Annuity Company of New York
Use this form to transfer the ownership of your policy.

Download PDF (49 KB)

Request for Co-Ownership Form # 16283
Aviva Life and Annuity Company
This form is to be utilized any time there will be more than one owner.

Download PDF (24 KB)

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