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Policy Service Forms

For your convenience, we have provided some commonly used forms to help you manage your policy(s). To request a form to make a policy change, simply choose the appropriate form from the list below, then:

  1. Print the form, complete and sign it.
  2. Fax or mail the form as stated in the instructions listed next to the form.
  3. Your form will be processed upon receipt. We will contact you if additional information is needed.

Note: Please do not save blank copies of these forms as they are periodically updated. Always return to the Web site to get the most current version.
 

Life/Annuity Policy Forms
  • Power of Attorney Certification
    Use this form to certify the validity of an attorney.
  • Beneficiary Designation
  • Automatic Deposit Authorization Agreement

     1. Use this form to automatically deposit funds into a specific financial institution.

    2. Print the form, complete and sign it.

    3. Fax your completed form to 800-754-6370 OR

    Mail to: Farm Bureau Life,

    PO Box 9168 , Des Moines , IA 50306

    4. Your form will be processed upon receipt. We will contact you if additional information is needed.

    Note: Please do not save blank copies of these forms as they are periodically updated. Always return to the Web site to get the most current version.

    If you have any questions call 800-247-4170, Monday – Friday 8:00 am – 4:30 pm CST .

  • Electronic Funds Transfer (EFT) Form

    1. Use this form to:

    -Set up automatic monthly withdrawals from your bank account to pay premiums

    -Change the bank account where your premiums are currently being withdrawn

    -Be sure to attach a voided check

    -The form must be signed by the bank account owner

    2. Print the form, complete and sign it.

    3. Fax your completed form to 800-754-6370 OR

    Mail to: Farm Bureau Life,

    PO Box 9168 , Des Moines , IA 50306

    4. Your form will be processed upon receipt. We will contact you if additional information is needed.

    Note: Please do not save blank copies of these forms as they are periodically updated. Always return to the Web site to get the most current version.

    If you have any questions call 800-247-4170, Monday - Friday 8:00 am - 4:30 pm CST.

  • Variable Policy Service Request
  • Systematic Withdrawal
  • Policy Service Request
     

    Policy Service Request

    If you want to CHANGE:

    Address

    Billing options (change amount, frequency, payor)

    Dividend Options

    Name

    Coverage

    Owner

    Beneficiary

     

     

    If you want to REQUEST:

    Loan (Life Only)

    Dividend (Life Only)

    Paid Up / Extended Term

    Partial Withdrawal

    Minimum Distribution (annuities)

    Surrender / Cancel Policy

    Lost Policy (fee applies)

     

     

    If you want to SET UP:

    Electronic Funds Transfer (EFT)

    Direct Deposit form

Auto/Home/Property Policy Forms
  • P&C Electronic Funds Transfer Form (EFT)
  • Good Student Credit
     

    Good Student Discount Form

     

     

     

     

    1. Use this form to apply for or continue the Good Student discount on your Farm Bureau Member's Choice policy.

    2. Print the form, complete and sign it.

    3. Fax your completed form to 877-860-2902

    OR

    Mail to: Farm Bureau Property & Casualty Insurance Co.

                5400 University Ave.

                West Des Moines IA 50266-5950

    4. Your form will be processed upon receipt. We will contact you if additional information is needed.

     

     

     

     

    Note: Please do not save blank copies of these forms as they are periodically updated. Always return to the website to get the most current version.

    If you have any questions call 866-399-3237, Monday - Friday 7:00 am – 7:00 pm or Saturday 9:00 am – 1:00 pm Central.

  • Good Student Credit Form

    Good Student Discount Form

     

     

    1. Use this form to apply for or continue the Good Student discount on your Farm Bureau Member's Choice policy.

    2. Print the form, complete and sign it.

    3. Fax your completed form to 877-860-2902

    OR

    Mail to: Farm Bureau Property & Casualty Insurance Co.

                5400 University Ave.

                West Des Moines IA 50266-5950

    4. Your form will be processed upon receipt. We will contact you if additional information is needed.

     

     

    Note: Please do not save blank copies of these forms as they are periodically updated. Always return to the website to get the most current version.

    If you have any questions call 866-399-3237, Monday - Friday 7:00 am – 7:00 pm or Saturday 9:00 am – 1:00 pm Central.

Securities & services offered through FBL Marketing Services, LLC+, 5400 University Ave., West Des Moines, IA 50266, 877/860-2904, Member SIPC.


Property-casualty insurance products are offered through Farm Bureau Property & Casualty Insurance Company+* and Western Agricultural Insurance Company+*/West Des Moines, IA and are intended for residents of AZ, IA, KS, MN, NE, NM, SD and UT.

Fixed life insurance and annuity products are offered through Farm Bureau Life Insurance Company+*/West Des Moines, IA and are intended for residents of AZ, IA, ID, KS, MN, MT, ND, NE, NM, OK, SD, UT, WI and WY.

Variable life insurance and annuity products are underwritten by an insurance company that is not affiliated with our companies.

+Affiliates *Company providers of Farm Bureau Financial Services

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