Cotton States Life Insurance Company | Vision Financial: Worksite Administration for Voluntary Benefits and Combined Billing

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Cotton States Life Insurance Company

Please select from the forms listed below.

Attachment	Size
Assignment of Life Insurance Policy as Collateral Form (Form # LPOS-39)	74.63 KB
Attending Physcian's Statement for Accelerated Benefit Form (Form # LC-38)	24.63 KB
Authorization for Release of Information Form (Form # LUD-113)	16.16 KB
Census Form	40.95 KB
Claimant's Statement Form (Form # LC-10)	40.33 KB
Claimant's Statement of Disability Form (Form # LC-39)	55.47 KB
Electronic Fund Transfer Form (Form # LPOS 35)	53.72 KB
Financial Transaction Request Form (Form # LPOS-200)	57.89 KB
Notification of Termination / Cancellation Form (Form # 50-5016)	61.86 KB
Policy Change and Reinstatement Application Form (Form # LUD-102)	368.44 KB
Policyowner Service Change Request Form (Form # LPOS-105)	61.13 KB
Request for Underwriting Offer Form (Form # CSL-RUO-1)	111.1 KB