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Here is the data in regards to the form you were seeking to complete. It can show you how long it should take to fill out form allianz, exactly what fields you will have to fill in and several additional specific details.
| Question | Answer |
|---|---|
| Form Name | Form Allianz |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | allianz life forms, allianz forms, allianzlife com forms, allianz forms download |
Representative/Agent Change
Complete form and mail to address located on the bottom of this form.
Representative must be appointed with Allianz Life Insurance Company of North America. For Licensing, call 800.226.0574.
If not appointed, complete the Representative Appointment Request Form.
Representative’s name (print)
Name of broker/dealer
Representative’s business address |
Street, City, State, ZIP code |
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Business telephone number |
Business fax number |
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Individual changes
■Contract owner name
■Contract number
■I (we) the contract owner(s), want my (our) new representative to have telephone transfer access to my contract. Contract owner’s initials: ________
Block changes
■This is a block/bulk change — attach list of contract owners’ names
■This is a block/bulk transfer — attach list of contract numbers
Signatures
Individual changes |
■ Contract owner’s signature |
Date
OR
■Previous branch manager’s signature
Block changes
Date
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Accepting branch manager’s signature |
Date |
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FAX TO: 610.251.2337 MAIL TO: Allianz Life - Allianz Service Center, PO Box 1122, Southeastern, PA
QUESTIONS: Call the Allianz Service Center at 800.624.0197,