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Fillable Sf2823 Form: What You Should Know

Page is not available for some older files. Original version dated October 17, 1999. Page not available; updated Oct. 2017. Guidance Note: If there is a change in the beneficiary and the Insured/Assignee signs out, they must retype the beneficiary and must indicate any changes in the beneficiary.  FELL INSURED AND ASSIGNEE — RULE 2700 THIS DOCUMENT MUST BE NOTARIZED AND INSTRUMENTED IN ALL REPRESENTS OF THIS APPLICATION TO ALL OTHER COVERED REPRESENTATIVES OF THE APPLICANT. A COPY OF THIS DOCUMENT MUST BE MADE AVAILABLE AT THE APPLICANT'S DISPOSING FACILITY, OR THE APPLICANT'S OFFICE, UPON REGISTRATION IN THE VETERAN INSURANCE PLAN, OR VETERAN INSURANCE PLAN ADVERTISED BY THE COMPANY OR PROFESSIONAL OFFICE, THE APPLICANT, OR THE PROVIDER. Any and all errors and omissions in this application are the responsibility of the Insured/Assignee. The Insured/Assignee is responsible for verifying all information and for completing the application. If the Insured/Assignee has a personal financial statement covering the period that ends on or before 1/31/2018, the Insured may be automatically enrolled in the FELL. If the company has a policy that provides benefits to a personal financial statement for the Insured, and that policy was effective for that period, the Personal financial statement will NOT be necessary to complete and submit the application. If the company has a policy that provides this benefit to the company, the company may be automatically enrolled as a beneficiary of this life insurance plan. If the company does not have a policy providing the personal financial statement benefit, the personal financial statement will be used instead of the company's policy to verify the insurable interest. If the Insured/Assignee has an insurance policy with a policy name that exactly matches, the Insured/Assignee should call or write to the company to get a copy of the policy. If it is not known if a company has a policy that provides this benefit, the Insured/Assignee should check with the company if they are using a “personal financial statement.” The Insured/Assignee should have a copy of all insurance policy documents which are used to make policy documents available to the company.

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