Get Premium Payment Authorization Form - Vantis Life Insurance ...

Filling out the Premium Payment Authorization Form is an essential step for ensuring your premium payments are processed efficiently and accurately. This guide provides clear, step-by-step instructions to help users complete the form smoothly online.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by entering the name of the insured and the policy number at the top of the form. Ensure this information is accurate to avoid processing delays.
3. Select your payment frequency preference. Choose one of the following options: Initial Premium, Recurring Premiums, or Both Initial and Recurring Premiums.
4. For payment by credit card, check the appropriate box. Fill in the credit card type, account number, expiration date, cardholder name, and billing address. Ensure the cardholder’s signature is included at the end.
5. For payment by Electronic Funds Transfer (EFT), authorize the withdrawal from your account by checking the box and providing the financial institution's name and address. Complete the transit routing and account numbers, and specify the account type (Checking or Statement Savings).
6. If you want payments withdrawn on a date other than the policy due date, indicate your preferred date (e.g., 5th of the month, 10th of the month) or specify another date.
7. Attach a voided check to the form to provide your financial institution's correct ACH information.
8. Once all sections are filled out, review the form for accuracy. You can then save your changes, download, print, or share the form as needed.

Complete your Premium Payment Authorization Form online today for a hassle-free experience.