Allianz Change Of Agent Form Details

Are you looking for a new insurance provider? If so, Form Allianz may be the perfect option for you. We offer a wide range of coverage options, so you can find the protection that's right for your needs. Plus, our team is committed to providing outstanding customer service. We'll work with you to find the best policy at a price that fits your budget. Contact us today to learn more about our products and services.

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.

Form NameForm Allianz
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesallianz life forms, allianz forms, allianzlife com forms, allianz forms download

Form Preview Example

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







Business telephone number

Business fax number

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


Individual changes

Contract owner’s signature



Previous branch manager’s signature

Block changes





Accepting branch manager’s signature


FAX TO: 610.251.2337 MAIL TO: Allianz Life - Allianz Service Center, PO Box 1122, Southeastern, PA 19398-1122

QUESTIONS: Call the Allianz Service Center at 800.624.0197, Monday-Friday between 8:00 a.m. and 7:00 p.m. Eastern time



If you believe this page is infringing on your copyright, please familiarize yourself with and follow our DMCA notice and takedown process - click here to proceed .