Sales & Service Forms

All forms may be submitted electronically. If you are unable to find what you are looking for, contact us at (800) 617-2861 or email the Structured Settlements team.


Post Contract Issuance | Service Forms

  • image of Electronic Funds Transfer Agreement

    Electronic Funds Transfer (EFT) Agreement

    Return a completed and signed form to United of Omaha to have periodic payments deposited electronically to a U.S. bank account. An electronic copy is acceptable.

    RPD979 (PDF)
  • image of Address & Name Change Request

    Address & Name Change Request

    Return a completed and signed form to United of Omaha for change of address or name. An electronic copy is acceptable.

    RPD994 (PDF)
  • image of Beneficiary Change Request

    Beneficiary Change Request

    Return a completed and signed form to United of Omaha to request a beneficiary change designation if permitted by the settlement agreement. An electronic copy is acceptable.

    RPD1030 (PDF)
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Post Contract Issue Questions

For post contract issue questions, please contact our annuity service area:

Toll Free: 800-843-2455 Option 3. 

Select option 1 for policies issued after 2010. 

Select option 2 for policies issued prior to 2010.

Fax: 402-997-1900

Email: structuredservice@mutualofomaha.com

Monday – Friday | 7:00am - 4:30pm CST