Download Forms

The following forms are available for download in PDF format.  You must have Adobe Reader to view and print these forms.

Customer Info/Update Form-    New customers must complete and send or fax this form to us to set up your account.  This form is

                                                 also used to update changes to your information.

ACH Authorization Form     -   Complete and fax this form to us so we can deposit your fundings directly into your checking

                                    account.  Funds will normally be available the following business day and there is no charge to

                                    you for this service.

Request for Funding Form   -    Use this form to request a new funding.  Note: Many insurance companies require us to have
                                                 a fax copy of the completed Funeral Home Assignment and the Irrevocable Reassignment in
                                                 order to verify the policy (ies).

Assignment of Proceeds      -    This is a generic assignment form to be signed by the beneficiary that assigns the insurance policy

                                                to the funeral home.  Required for all fundings (many funeral homes already have their own version

                                                of this form).

Irrevocable Reassignment    -    This form reassigns the insurance policy from the funeral home to Funeral Funding of Michigan.

                                     Required for all fundings. 

                                                 Note: This form must be signed individually by the funeral home owner or director only.

Claim Checklist                   -    A tool to ensure all necessary documentation is completed and included with your claim.

Lost Policy Affidavit            -    This is a generic Lost Policy Statement (many insurance providers have their own form that must be used).

Release Info Authorization    -    Some insurance companies require the beneficiary (ies) to provide written authorization for us to

                                     verify policy information.  Completing this form may expedite the verification process.

Small Estate Affidavit            -   A generic form required for claims where the primary beneficiary is deceased and there is no

                                                contingent beneficiary listed on the policy or the contingent beneficiary is also deceased.

© 2008, Funeral Funding of Michigan, Inc.