Get (walmart Associates Use Only):

This guide provides clear instructions on how to fill out the (Walmart Associates Use Only) form online. By following these steps, you can efficiently complete the necessary information to set up or modify your direct deposit for claims payments.

Follow the steps to complete the form accurately.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Select the transaction type by indicating whether you are setting up a new direct deposit, canceling an existing setup, changing your financial institution, or changing your account number.
3. Fill in your policy or certificate holder information, including your name, home phone number, policy/certificate number(s), and social security number.
4. Indicate your financial institution choice by selecting either checking, savings, or Money Network Paycard. Then, provide the financial institution's name and address, account number, and electronic routing number.
5. If applicable, add the account number associated with your Walmart Money Network Paycard, which can be found on the welcome letter or obtained by contacting customer service.
6. Review the authorization section, understanding that by signing, you are allowing American Heritage Life Insurance Company to credit your account for claims payments.
7. Sign and date the form, and print your name as required.
8. Attach a voided check or a bank letter if you are using a checking account.
9. Submit the completed form by faxing it to 1-866-424-8482 or mailing it to the specified address. Make sure to keep a copy for your records.

Complete your (Walmart Associates Use Only) form online today for efficient claims processing.