Permanent Life Forms
Click the buttons below to open and download each form
This completed form should be submitted to:
Claim Department
PO Box 6700
Scranton, PA 18505-0700
Telephone 1-800-225-4500 Fax 312-351-6930
Claim Department
PO Box 6700
Scranton, PA 18505-0700
Telephone 1-800-225-4500 Fax 312-351-6930