Designation and Name Change Form
Policy Change Form
Request for Values Form
Application for Policy Changes - New York
Application for Policy Changes - all other states
Request for EFT Premium Paying Plan
Use the Request for EFT Premium Paying Plan to authorize premium payments via electronic funds transfer.
Mail completed and signed forms to P.O. Box 1381, Binghamton, NY 13902-1381 or fax to 1-866-253-9459.