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Policyholders / Download Forms / Policyholder Forms

The documents listed below are PDF documents that require the Adobe Acrobat Reader® to be installed on your system. Click here to download a free version
Policyholder Forms
HIPAA Authorization/Disclosure - Policyholder Information Download
Policyholder Change & Service Request Download
Policyholder Change of Beneficiary Request Download
Concord Heritage Life Policyowners Service Request Download
Child Term Rider Conversion Form Download
Mail policyholder forms to the following location:
Customer Care Center
Allstate Workplace Division
1776 American Heritage Life Drive
Jacksonville, FL 32224-6687
   
Fax policyholder forms to the following phone number: 1-972-510-1795
   
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