Use our Service Request Form to request any of the following:
- Beneficiary change
- Name change
- Address change
- Ownership transfer
- A copy of your certificate
To ensure that your service request is handled quickly and accurately, please print the form and then do the following:
- Complete the top portion of the first page, including your certificate number, name, and contact information.
- Place a check mark in the section(s) you wish to amend, and provide the required information.
- Sign and date the bottom portion of the second page.
For your convenience, you can scan the signed and completed form and email it to firstname.lastname@example.org or fax it to: 1.866.849.2974 .
You are also welcome to mail it to:
Aflac NY Group Product Administration
PO Box 427
Columbia, SC 29202
Need help? Call our Customer Service Center toll-free at 1.866.849.2964 .