Form 0009001 is the Internal Revenue Service's (IRS) way of asking for information about your business. It's also the first step in applying for an Employer Identification Number (EIN). This form can be completed online or by mail, and it's important to provide accurate information so that the IRS can process your application quickly. In this blog post, we'll walk you through each section of Form 0009001 and explain what information is required. We'll also provide tips on how to submit a complete and accurate application.
If you'd like to look at a few specific details relating to the form you are going to use, here is the information you might like to read prior to filling out the form 0009001.
| Question | Answer |
|---|---|
| Form Name | Form 0009001 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | primerica beneficiary, primerica multi purpose change form, primerica change of agent form, multi purpose change form primerica |
BENEFICIARY CHANGE FORM
Administrative Office:
PO Box 13080
Springfield, IL
Name of Insured: ____________________________________________
Name of Owner: _____________________________________________
Universal Guaranty Life Insurance |
(800) |
UG/Genworth Life & Annuity |
(866) |
IdeaLife Insurance Company |
(866) |
The Independent Order of Vikings |
(877) |
|
|
Policy Number: _________________________
Phone: ________________________________
PRIMARY
BENEFICIARY
I hereby revoke all prior designations of beneficiary and optional modes of settlement under this policy.
Change the beneficiary to:_________________________________________________________________________
Beneficiary Social Security Number: _________________________ Beneficiary Date of Birth:_________________
Beneficiary’s relationship to the Insured is: ___________________________________________________________
Address (Please Print): _____________________________________________________________________________
Number and StreetCityStateZip Code Phone Number:______________________________________________
CONTINGENT BENEFICIARY
Change the Contingent Beneficiary to: _______________________________________________________________
Contingent Beneficiary Social Security Number: _______________________________________________________
Contingent Beneficiary Date of Birth:________________________________________________________________
Whose relationship to the Insured is: ________________________________________________________________
Address (Please Print): _____________________________________________________________________________
Number and StreetCityStateZip Code Phone Number:___________________________________________________
AFFIRMATION
I hereby affirm that to the best of my knowledge and belief, the following statements are true and correct:
Premiums for this policy were funded by personal assets, or any financing agreement was secured by personal assets and disclosed to the Company.
The policy owner made no agreement to settle the policy before or during the first two years after policy issuance.
The policy owner responded truthfully to the Company’s inquiry at application regarding whether a life expectance valuation was obtained and a copy of any evaluation was provided to the Company.
Any financial arrangement, trust or other device that conceals ownership of the policy was disclosed to the Company prior to policy issuance.
YOUR SIGNATURE BELOW AFFIRMS THAT THESE STATEMENTS
ARE TRUE AND CORRECT TO THE BEST OF YOUR KNOWLEDGE AND BELIEF.
I direct that any endorsement or change of the policy as requested above be effected by return of a confirmation letter with the Company's acknowledgement. I certify that I am not now disabled, and that no proceedings in bankruptcy are pending.
Signature of Policy Owner:__________________________________ ____/____/____ Joint Owner:______________________________ ____/____/____
*Signature of spouse if community property state
*Community Property States AZ,CA,ID,LA,NV,NM,TX,WA,WI
Witness:(Notary Official):___________________________________ ____/____/____
Stamp or Seal Required
Form #0009001B (rev 12/16)
