Form Ng-Enrl-La - Enrollment For Group Life Insurance, Dd Form 2558 - Authorization To Start, Stop Or Change An Allotment

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Instructions for filling out and mailing the:

•

American Equity Enrollment Form

•

Authorization to Start Allotment Form

When filling out the Enrollment Form, ensure that you select the desired coverage amounts.

a. Select only 1 coverage amount for the Guard Member, 1 for the Dependent(s), and 1 for

the Spouse (Dependent and Spouse are optional, but keep in mind that for dependents,

one premium covers ALL your dependent children, regardless of the number of children

you have).

b. The information that you put on the first page will automatically populate some of the

boxes on page 2, so you won’t have to retype the information. But, if you change the

info on page 2, it will also change it on page 1 (like your name or address for example).

c. The most important thing is to print and sign the forms. Although you can save the

forms as a file on your computer, we need to have a “wet signature” in order to process

the coverage, so it is important that you mail in the signed forms.

2. When filling out the Allotment Form, ensure that you sign the form at the bottom.

a. In blocks 7 and 8 of the Allotment Form, leave those blank. This is in the event that

something changes before the allotments start, we won’t have to re-accomplish the

Allotment Form in order to process your allotment.

3. Once you have completed, printed, and signed both forms, mail them to:

CMSgt (Ret) John M. Harris

694 S. Rue Marcel

Gretna, LA 70056

If you have any questions, please call 504-388-5423

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