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 - OK

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 -OK

 

High Blood Pressure Questionnaire

 

 

HIV Form - OK

 

 

Military Questionnaire

 

 

Parent Consent Form for Child

 

 

Proposed Insured Consent Form

 

 

Replacement Form -  OK

 

 

Statement of Good Health

 

 

Stroke Questionnaire

 

 

Tobacco Use Questionnaire