Get Kemper Sample Application - Chelsea Insurance Group

Filling out the Kemper Sample Application for Chelsea Insurance Group is an important step in obtaining life insurance coverage. This guide provides clear, step-by-step instructions to assist you in completing the application efficiently and accurately.

Follow the steps to fill out the Kemper Sample Application online.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by entering the full legal name of the proposed insured in the designated field.
3. Select the gender of the proposed insured by marking either 'Male' or 'Female'.
4. Provide the Social Security number of the proposed insured in the appropriate area.
5. Input the date of birth of the proposed insured in the specified format.
6. Fill in the legal residence address, including street, city, state, and zip code.
7. Complete the mailing address section, if different from the legal residence.
8. Enter the phone number and email address of the proposed insured.
9. If the owner of the policy is different from the proposed insured, provide their name.
10. Indicate any existing life insurance or annuity contracts in force by answering the corresponding questions.
11. Select the policy amount you wish to apply for from the provided options.
12. Specify the payment mode as either annual or monthly with automated bank account withdrawal.
13. Enter the name and relationship of the primary beneficiary, along with their date of birth.
14. Read and acknowledge the agreements and signatures section by signing as the proposed insured and, if applicable, the owner of the policy.
15. If opting for bank draft authorization, sign the authorization and provide a voided check.
16. Review all entries for accuracy and ensure all required fields are filled out before proceeding.
17. Finally, you can save changes, download the completed form, print it, or share it as needed.

Complete your Kemper Sample Application online today for peace of mind regarding your life insurance coverage.