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