Fillable aflac policy cancellation form

AFLAC CANCELLATION NOTICE Date I do hereby request cancellation printed name of insured of my Policy. Type of policy policy number of only myrider on my type of rider Please make this cancellation effective. date Insured s signature Insured s SSN Associate/Agent name and writing number American Family Life Assurance Company of Columbus Aflac Worldwide Headquarters Columbus Georgia 31999 1.
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aflac policy cancellation form