1. Use this form to:
-Make changes on your policy such as
ü Premium payments
ü Dividend options
-Request a loan
-Request a dividend withdrawal
-Request a partial withdrawal on a universal life plan
-Request surrender of the policy
-Request EFT (electronic forms transfer)
-Request entity information
-Request trust information
-Change beneficiary designation
2. Print the form, complete and sign it.
3. Fax your completed form to number located on top right corner of form 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 .