Home Office:         


Administrative Office:  

 7633 East 63rd Place, Suite 230, Tulsa, Oklahoma 74133
 PHONE:  (918) 249-2438   FAX: (918) 249-2478

PO Box 5205, Frankfort, Kentucky 40602-5205
PHONE: (866) 440-1357   FAX (502) 875-7084

 Partial listing of Administrative Employees and Extension Numbers
   

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UNDERWRITING FORMS POLICY SERVICE FORMS MISCELLANEOUS FORMS
   
Adult Proposed Insured Consent Age Correction Form Claim Form
Aviation Questionnaire Beneficiary Change Form Medical Requirements Form
Avocation Questionnaire Cancel Policy - No Cash Value Form W-9 Certified
Asthma Questionnaire Cash Surrender Form Trinity Life Insurance Privacy Notice
Diabetes Questionnaire Change Name Form Annuity Disclosure Form
Driving Questionnaire Change Ownership Form Annuity Buyer's Guide
Drug/Alcohol Questionnaire Change Premium Mode Form Oklahoma Guaranty Notice
Epilepsy Questionnaire Change Premium Payor HIPAA Form
Exam form for Paramedic Duplicate Policy or Certificate Request Anti-Money Laundering Training Manual
Family History Questionnaire Lost Policy Affidavit Anti-Money Laundering Test
Financial Questionnaire Preauthorized Check Transfer Form-Monthly  
Foreign Travel Questionnaire Policy Loan Agreement  
General Questionnaire Reinstatement Form  
High Blood Pressure Questionnaire    
HIV Form    
Military Questionnaire    
Parent Consent Form for Child    
Proposed Insured Consent Form    
Replacement Form     
Statement of Good Health    
Stroke Questionnaire    
Tobacco Use Questionnaire