Policy Change Forms
We are making these frequently requested forms available to you as PDF documents. The forms require your signature and, in some cases, the signature of a witness and/or notary. So although you may complete the form online, you will then need to print and sign it and forward to your agent or the Home Office.
Use this form to release all interest in the policy and assign it to another. This should not be used for collateral. The policy number is required along with name, date of birth and Social Security number of new primary and contingent owner. It must be signed by the previous primary and contingent owner and witnessed.
The form can be completed online, then printed and signed. Click the link below and the form will open in a new window. Once completed and printed, clear the form and/or close the window.
You may mail or deliver the signed and witnessed form to your agent or to the address below:
Farm Bureau Life Insurance Company of Michigan, 7373 W. Saginaw Hwy., PO Box 30200, Lansing, MI 48909-7700
Use this form to release all interest in the policy and assign it to another. This should not be used for collateral. The policy number is required along with name, date of birth and Social Security number of new primary and contingent owner. It must be signed by the previous primary and contingent owner and witnessed.
The form can be completed online, then printed and signed. Click the link below and the form will open in a new window. Once completed and printed, clear the form and/or close the window.
You may mail or deliver the signed and witnessed form to your agent or to the address below:
Farm Bureau Life Insurance Company of Michigan, 7373 W. Saginaw Hwy., PO Box 30200, Lansing, MI 48909-7700
Use this form to change the beneficiary on your policy. The policy number is required along with the name, Social Security number, birth date, address and relationship of all beneficiaries. The form must be signed by the policy owner and witnessed. The second page includes instructions.
The form can be completed online, then printed and signed. Click the link below and the form will open in a new window. Once completed and printed, clear the form and/or close the window.
You may mail or deliver the signed and witnessed form to your agent or to the address below:
Farm Bureau Life Insurance Company of Michigan, 7373 W. Saginaw Hwy., PO Box 30200, Lansing, MI 48909-7700
Use this form to make a loan repayment or submit additional premium on your policy. The policy number is required along with the amount being submitted.
The form can be completed online, then printed and signed. Click the link below and the form will open in a new window. Once completed and printed, clear the form and/or close the window.
You may mail or deliver the signed and witnessed form to your agent or to the address below:
Farm Bureau Life Insurance Company of Michigan, 7373 W. Saginaw Hwy., PO Box 30200, Lansing, MI 48909-7700
Use this form to provide Taxpayer Identification number in compliance with the Taxpayers Relief Act of 1997. The policy number and policy owner’s Social Security or Tax ID number and mailing address are required. Also required is the insured’s name and Social Security number. The form does not need to be witnessed.
The form can be completed online, then printed and signed. Click the link below and the form will open in a new window. Once completed and printed, clear the form and/or close the window.
You may mail or deliver the signed and witnessed form to your agent or to the address below:
Farm Bureau Life Insurance Company of Michigan, 7373 W. Saginaw Hwy., PO Box 30200, Lansing, MI 48909-7700
Use this form to notify administrators of the correct amount of Michigan income tax to withhold from your pension or annuity payment(s). The insured’s name, address, Social Security number and marital status are required. The second page includes complete instructions.
The form can be completed online, then printed and signed. Click the link below and the form will open in a new window. Once completed and printed, clear the form and/or close the window.
You may mail or deliver the signed and witnessed form to your agent or to the address below:
Farm Bureau Life Insurance Company of Michigan, 7373 W. Saginaw Hwy., PO Box 30200, Lansing, MI 48909-7700
Withholding Certificate for Michigan Pension or Annuity Payments
Electronic Funds Transfer Form
View our Electronic Funds Transfer (EFT) Form.