To submit this form, mail it to the appropriate address: Standard Address: PO Box 818005, Cleveland, OH 44181. For variable life service, use Variable Life Service Center: PO Box 818016, Cleveland, OH 44181. You can also fax it to 855-601-1834 (Standard) or 844-430-2639 (Variable Life Service). Ensure all required fields are completed accurately. My advice is to double-check all entries before submission to avoid processing delays.

Make sure to submit your policy loan application before the end of each calendar year to ensure timely processing.

This form is used to apply for a policy loan against an existing life insurance policy with American General Life Insurance Company. It allows policyholders to borrow from the value accumulated in their policy. Completing and submitting this form accurately ensures that your loan request is processed efficiently.

• 1. Policy Number: Enter the policy number for which you are requesting the loan.
• 2. Insured/Annuitant Name(s): Provide the full names of the insured or annuitant.
• 3. Owner Name: Enter the name of the policy owner.
• 4. Address: Provide the current address of the policy owner.
• 5. SSN/ITIN or EIN: Enter the Social Security Number, Individual Taxpayer Identification Number, or Employer Identification Number as applicable.
• 6. Primary Phone: Enter the primary contact phone number.
• 7. Alternate Phone: Provide an alternate contact phone number, if available.
• 8. Email Address: Enter the email address for communication about the policy loan.
• 9. Co-Owner Name: Provide the co-owner's name, if applicable.
• 10. Policy Loan Amount: Specify the loan amount you wish to borrow from your policy's value.
• 11. Signature: Sign the form to acknowledge the loan application and policy terms.
• 12. Date: Enter the date when the form is signed.

Failure to submit this form can result in delays or denial of your policy loan request.

• Loan Processing Delays: Your loan application will not be processed without the required form submission.
• Potential Denial: The insurance company may deny your loan request if the form is not received.
• Missed Communication: Failure to submit the form can lead to missed updates and important communication regarding your policy loan.

• 1. Policy Loan Application: Complete this form to request a loan from your policy's accumulated value.
• 2. Change of Address: Use the form to update your address along with the loan application.
• 3. Tax Certification: Provide your tax identification details for IRS certification.
• 4. Trust-Owned Policies: Trustees can use this form to request a loan on trust-owned policies.
• 5. Business-Owned Policies: Businesses can use this form to apply for a loan on business-owned policies.