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-Change the bank account where your premiums are currently being withdrawn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