Manage policies

Authorize or change automatic premium bank information

Instructions

Authorize electronic drafts easily with this form.

  1. Complete the financial institution section
    Complete this section of the form with the following:
    • Name of institution
    • Type of account
    • Routing number
    • Account number
    • Policy number
  2. Sign the signature section
    Complete the signature section with account holder and policy owner printed name, signature and date.
  3. Submit form
    Return the completed forms with any required documentation via postal mail, overnight mail or fax to our service center.

    Postal mail
    糖心动漫vlog Service Center
    P.O. Box 81497
    Lincoln, NE 68501-1497

    Overnight mail
    糖心动漫vlog Service Center
    777 Research Drive
    Lincoln, NE 68521

    Fax
    800.281.5777
    Allow 3 business days for faxed documents to enter our processing system.
  4. Allow 15 days to process
    糖心动漫vlog will process the request within 15 business days of receipt if in good order.
  5. Confirm updates
    We will mail a confirmation letter that the request was processed to the owner's address on record.
admin 5778

Pre-Authorized Check (PAC) Authorization Form [ADMIN 5778]

"糖心动漫vlog" is the marketing name for Fidelity & Guaranty Life Insurance Company issuing insurance in the United States outside of New York. Life insurance and annuities issued by Fidelity & Guaranty Life Insurance Company, Des Moines, IA.