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  • Gira-3 2004

Get Gira-3 2004-2026

Sted Effective Date of Change Application is hereby made to change the above numbered policy as indicated below. The policy is attached for such change. អ Yes អ No TERM INSURANCE ONLY ■ Reduce amount or ■ Convert coverage at attained age on life of __________________________________________________________ Requested Plan Requested Amount* $ Method of Payment If this is a conversion of a term rider, the basic policy is to be ■ continued, ■ cancelled, and any cash value paid to me.

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How to fill out the GIRA-3 online

The GIRA-3 is an important document for requesting changes to a policy with Globe Life And Accident Insurance Company. This guide provides clear instructions to help you complete the form accurately and efficiently online.

Follow the steps to effectively fill out the GIRA-3 form online.

  1. Click the ‘Get Form’ button to obtain the GIRA-3 form and open it in your browser for editing.
  2. In the first section, print the first, middle, and last names of the primary insured. Be sure to provide the requested effective date of the change.
  3. Indicate if the application is to change the policy by checking 'Yes' or 'No'.
  4. For term insurance, specify if you want to reduce the amount or convert coverage. Fill in the requested plan and amount, including the desired method of payment.
  5. If this request involves converting a term rider, detail whether the basic policy is to be continued or canceled.
  6. If additional insurance is desired, provide the amount desired and complete Part 2 of the form.
  7. For permanent insurance, specify the requested amount and method of payment. Include any requests for additional benefits.
  8. Complete any additional requests and corrections as indicated in the Other Requests section.
  9. Finally, review all entered information for accuracy, and then save your changes. You may download, print, or share the completed form as needed.

Complete your GIRA-3 form online today to ensure your policy changes are processed smoothly.

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