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
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Electronic Funds Transfer (EFT) Agreement
RPD979 (PDF)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.
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Address & Name Change Request
RPD994 (PDF)Return a completed and signed form to United of Omaha for change of address or name. An electronic copy is acceptable.
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Beneficiary Change Request
RPD1030 (PDF)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.
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