I have reviewed the benefits of the plan and have decided to cancel my coverage. Aflac policy cancellation requests can be initiated by contacting aflac online or by phone. I am requesting that policy number(s)______________________ be canceled upon the issuance of my new policy. Web submit a cancellation form online: You may need to fill out a cancelation form.

*cancellation of riders on existing coverage should be completed using the request for change form (hl0046) or the applicable product application for downgrade. I, , do hereby request cancellation (print name of insured) of policy. Please closely follow the instructions on the form to receive the most efficient service. Web american family life assurance company of columbus (aflac) worldwide headquarters • 1932 wynnton road • columbus, georgia 31999 1.800.992.3522 telephone • 1.800.448.8922 fax • aflac.com m0784 m0784.3 1/14

(name and writing number) american family life assurance company of columbus (aflac) x worldwide headquarters: Billing name (if different than policyholder/certificateholder) American family life assurance company of columbus (herein referred to as aflac) attention:

*cancellation of riders on existing coverage should be completed using the request for change form (hl0046) or the applicable product application for downgrade. Aflac policy cancellation requests can be initiated by contacting aflac online or by phone. Reach out to your employer’s human resource office and let them know that you want to cancel the aflac insurance policy that you have from them. Web download our policy change forms online from aflac for name, beneficiary, add & delete a person, where each type of change has its own specific form. (name and writing number) american family life assurance company of columbus (aflac) x worldwide headquarters:

(please print) i have applied for a new lifeassurance policy with aflac; I have reviewed the benefits of the plan and have decided to cancel my coverage. Web (type of policy) (policy number) please make this cancellation effective _____.

Web (Type Of Policy) (Policy Number) Please Make This Cancellation Effective _____.

Please closely follow the instructions on the form to receive the most efficient service. I have reviewed the benefits of the plan and have decided to cancel my coverage. Here’s information on how to cancel both your own aflac policy and the policy of a deceased loved one. Printed name of authorized employer plan administrator.

Web You Can Download A Service Request Form From Our Web Site (Located Under The Service Request Tab) Or Call Our Customer Service Center At 800.433.3036 To Request The Form By Mail.

Steps for canceling a deceased loved one’s aflac insurance policy. If your medicare supplement policy was issued on or after 10/01/2012, call us at 855.207.2078. (name and writing number) american family life assurance company of columbus (aflac) x worldwide headquarters: Here’s how you can cancel a whole life insurance policy:

Web Cancellation/Change Of Coverage Please Check One:

This policy is intended to replace my current aflac policy(ies). If your medicare supplement policy was issued prior to 10/01/2012, call us at 800.992.3522. Web if your medicare supplement policy was issued by aflac tier one in or after 2022, call us at 833.692.5692. (type of policy) (policy number) please make this cancellation effective 7/01/2020 insured’s signature:

300 Southborough Drive, Suite 200.

American family life assurance company of columbus (herein referred to as aflac) attention: (please print) i have applied for a new lifeassurance policy with aflac; Web if you decide you don’t need life insurance anymore, you can contact your insurance provider and inform them of your decision to terminate the policy. I am requesting that policy number(s)______________________ be canceled upon the issuance of my new policy.

Web you can download a service request form from our web site (located under the service request tab) or call our customer service center at 800.433.3036 to request the form by mail. You may need to fill out a cancelation form. Web aflac cancellation notice for individual policies date: Web all you need to do is to pick the aflac cancellation notice m0784 form, complete the needed areas, add fillable fields (if necessary), and certify it without having second guessing about whether or not your signed document is legally binding. (print name of insured) of my ________________________________________ policy __________________________.