The following Homesteaders Life Company insurance service forms are available in PDF format. Please select the appropriate form, print and complete. The form may be mailed, faxed or emailed to our office.
Our mailing address is PO Box 1756, Des Moines, IA 50306-1756. If emailing, please send to firstname.lastname@example.org. Our fax number is 515-440-7695.
If you have any questions regarding the completion of these forms, please contact our customer service team at 800-477-3633. Our business hours are 8 a.m. to 4 p.m. Monday through Friday, and 8 a.m. to 1 p.m. Friday (Central time).
This form is required to add additional children or grandchildren after a Child/Grandchild rider has been issued with the primary coverage insurance policy.
Additional Spanish-language translations of this form will be available soon.
This form is used to add a single premium rider to an existing Homesteaders policy. The minimum premium requirement for the rider is $100. If the policy is funding a prearranged funeral agreement, a representative of the assigned funeral home must also sign the form before submitting to Homesteaders. A copy of the completed form should be retained by the policy owner and, if applicable, the associated funeral home.English Español