State Farm Life Insurance Policy and Annuities Request Letter
This file allows you to request changes to your State Farm life insurance policy, annuities, or related records. It includes sections to withdraw values, convert policies, change beneficiaries, and more. The form is divided into seven parts for ease of use.
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How do I fill this out?
To fill out this form, start by identifying the changes you want to make to your policy. Then, complete the appropriate sections and provide any additional required information. Finally, submit the form according to the provided instructions.

How to fill out the State Farm Life Insurance Policy and Annuities Request Letter?
1
Identify the changes you need to make.
2
Complete the relevant sections of the form.
3
Provide any additional required information.
4
Sign the form where indicated.
5
Submit the form as instructed.
Who needs the State Farm Life Insurance Policy and Annuities Request Letter?
1
Policyholders wanting to withdraw values from their life insurance policies.
2
Policyholders needing to convert their term insurance policies.
3
Individuals looking to change beneficiaries on their policies.
4
Customers aiming to transfer money electronically from their policies.
5
Policyholders needing to update their personal information with State Farm.
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Download the form for submission.

What are the instructions for submitting this form?
To submit this form, follow these instructions: Complete the form accurately, ensuring all necessary fields are filled. Attach any additional required documents. Submit the form to the State Farm Life Operation where your policy is serviced. You may submit via mail, fax, or email, as provided in the form instructions. For mail submission, send to State Farm Life Insurance Company, Home Office, Bloomington, IL 61710. Fax numbers and email addresses can be found in the form instructions. Ensure all information is complete for timely processing.
What are the important dates for this form in 2024 and 2025?
Please refer to the form instructions for any relevant dates in 2024 and 2025.

What is the purpose of this form?
The purpose of this form is to enable State Farm policyholders to request changes to their life insurance and annuities policies. This includes withdrawing values, converting policies, changing beneficiaries, and updating personal information. Using this form ensures that policyholders can securely and accurately manage their policies with State Farm.

Tell me about this form and its components and fields line-by-line.

- 1. Part A - Policy Values (Non-Tax Qualified Policies): For withdrawing values from non-tax qualified policies.
- 2. Part B - Policy Values (Annuities and Tax Qualified Policies): For withdrawing values from annuities or tax-qualified policies.
- 3. Part C - Other Changes: To request other changes such as dividend option change or mode change.
- 4. Part D - Term Insurance Conversion: To convert your term insurance policy or rider.
- 5. Part E - Change of Beneficiary: To request a change of beneficiary.
- 6. Part F - Electronic Transfer: To request an electronic transfer of money from your State Farm life policy.
- 7. IRS Form W-9: For requesting an ownership change or term conversion.
What happens if I fail to submit this form?
Failure to submit this form may result in the inability to process your requested changes.
- Delayed Policy Changes: Requested changes to your policy may be delayed or not processed.
- Loss of Benefits: You may miss out on potential benefits linked to timely changes.
How do I know when to use this form?

- 1. Policy Value Withdrawal: For withdrawing values from your policy.
- 2. Policy Conversion: For converting your term insurance policy.
- 3. Change Beneficiary: For changing the beneficiary on your policy.
- 4. Update Personal Information: For updating your personal information with State Farm.
Frequently Asked Questions
How do I fill out the form?
Identify the changes needed, complete relevant sections, sign, and submit the form.
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Use PrintFriendly's signature tool to add a digital signature.
Can I share the form electronically?
Yes, use PrintFriendly's share feature to send the form via email or direct link.
Is there a fee to edit this form?
PrintFriendly offers the tools needed to edit the form at no additional cost.
What sections are included in the form?
The form includes sections for withdrawals, conversions, beneficiary changes, and more.
What should I do if I need to make multiple changes?
Complete the relevant sections for each change needed.
Do I need to submit any additional documents?
Refer to the form instructions to determine if additional documents are required.
Can I request a policy update via the form?
Yes, you can use the form to update your policy information.
How do I download the completed form?
After editing, save the form and use the download option on PrintFriendly.
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