Do you need to request repayment of a loan from a borrower? Whether it is an installment payment or a lump sum, ensuring that funds are collected in an organized and structured manner is vital for any successful loan management system. This blog post will discuss the essential elements of creating an effective loan request repayment form. From identifying important contact information to understanding legal requirements, we’ll cover everything needed to create a fool-proof document for tracking loan amounts owed by your borrowers. Stay tuned as we walk through this crucial tool for maintaining accurate records and protecting both lender and borrower!
| Question | Answer |
|---|---|
| Form Name | Loan Request Repayment Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | Assignee, YR, forms, Repayment |
Monumental Life Insurance Company
Transamerica Life Insurance Company Western Reserve Life Assurance Co. of Ohio Administrative Office located at:
4333 Edgewood Road N.E., Cedar Rapids, IA
FAX
Loan Request/Repayment
Policy/certificate number (s)___________________________ |
Insured/Annuitant__________________________ |
Owner____________________________________________ |
Phone Number_____________________________ |
Fill out all required information in sections 1 and 2 and sign below.
1.Loan Request
Select one:
_____A cash loan for $ ___________________ (In addition to present loan, if any).
_____A cash loan of accumulated interest only (Limited to single premium universal life).
_____A cash loan for the largest amount available.
_____A loan to pay premiums on policy # __________________, due date ______/______/ _____.
MO DAY YR
_____Add the Automatic Premium Loan (APL) option to my policy.
2.Loan Repayment
Increase the amount I am billed each regular period (monthly, quarterly, etc.) by $________________
(Minimum $10.00)
Insured /Annuitant____________________________________ |
____________________________________ |
||
Signature |
Date Signed |
Social Security Number |
Date of Birth |
Owner_____________________________________________ |
____________________________________ |
||
Signature |
Date Signed |
Social Security Number |
Date of Birth |
Assignee____________________________________________
Signature Title Date Signed
Spouse__________________________________________________
Signature- (if none, indicate, NONE)
32913 0908