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Great-West Life & Annuity Insurance Company ||| Individual Variable Universal
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All documents are in PDF format. To read them, fill them out, or print them, you need the Adobe Acrobat Reader. If you don't already have it, you can download it for free by going to the
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Mail forms to:
Individual VUL Customer Service 9T2
Great-West Life & Annuity Insurance Company
8515 E. Orchard Road
Greenwood Village, CO 80111
   
Form 598 Beneficiary Designation
Form 320 Request for Electronic Funds Transfer
Form 51 Change of Name
Form CL1002 Change of Ownership
Form VL HIPAA Authorization
Form VL3055 Automatic Account Rebalancing
Form VL3064 Dollar Cost Averaging
Form VL3069 Life Policy Surrender Request
Form VL3070 Lost Policy Affidavit
Form VL3081 Policy Loan/Withdrawal/Change Request
Form VL3087 Transfer/Payment Allocation
Form W-9 Request for Taxpayer Identification Number
   
  Canada Life Insurance Company of America (“CLICA”) has been merged with Great-West Life & Annuity Insurance Company (“Great-West”) effective September 30, 2009. Any contract of insurance that was issued and administered by CLICA has been assumed by operation of law by Great-West Life & Annuity Insurance Company as of September 30, 2009, provided that the contract was in-force on this date.