Forms
Forms may be sent in by MAIL – 1891 Financial Life, 200 N. Martingale Rd., Ste. 405, Schaumburg, IL 60173
- Recommender Award
- Agent of Record Change Form
- Transfer of Funds
- Change of Beneficiary
- Change of Owner
- Lost Certificate (Policy) Statement
- Annuity Contribution
- Payments by Credit Card, Debit Card, or Electronic Funds Transfer (EFT)
EFT from may also be sent in by: FAX – 847-342-4556 or EMAIL – info@1891FinancialLife.com
Underwriting Guides
Life Insurance Applications
Your Questionnaires are below the life application list.
- CA Life Application and Senior (65+) Presentation 24-hours Before Meeting
- CO / IL / IN / IA / MI / NE / WI Life Application
- KS Life Application
- MN Life Application
- MO Life Application
- MT Life Application
- ND Life Application
- OH Life Application
- OR Life Application
- SD Life Application
- WA Life Application
Life Application Questionnaires
Questionnaire Keys, these charts show when to use a questionnaire: CA, ND/SD, OR, all other states
- Alcohol Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Aviation Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Criminal History Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Diabetes Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Driving History Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Drug Use Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Foreign Travel Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Hypertension Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Marijuana Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Mental Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Military Questionnaire: CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Respiratory Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Seizure Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Sleep Apnea Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
- Sport, Amusement, Avocation Questionnaire: CA, CO / IL / IN / IA / KS / MI / MN / MO / MT / NE / OH / WA / WI, OR, ND / SD
Simplified Issue – Life Insurance Applications
- CA Simplified Issue (long) Life Application and Senior (65+) Presentation 24-hours Before Meeting
- CO / IL / IN / IA / MI / NE / WI Simplified Issue Life Application
- KS Simplified Issue Life Application
- MN Simplified Issue Life Application
- MO Simplified Issue Life Application
- MT Simplified Issue Life Application
- ND Simplified Issue Life Application
- OH Simplified Issue Life Application
- OR Simplified Issue Life Application
- SD Simplifed Issue (long) Life Application
- WA Simplified Issue Life Application
Annuity Applications
Annuity Compensation Disclosure – Pre application form for Qualified Annuity plans, click here for CA or OR
- CA Annuity Application and Senior (65+) Presentation 24-hours Before Meeting
- CO / IA Annuity Application
- IL / MI / NE Annuity Application
- IN Annuity Application
- KS Annuity Application
- MN Annuity Application
- MO Annuity Application
- MT Annuity Application
- ND Annuity Application
- OH Annuity Application
- OR Annuity Application
- SD Annuity Application
- WA Annuity Application
- WI Annuity Application