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Assignment Of Insurance Policy

This form transfers and assigns an insurance policy. The form provided here is simply a sample of what the actual form looks like.

ASSIGNMENT OF INSURANCE POLICY

BE IT KNOWN, for value received, the undersigned of ________________________

hereby irrevocably transfers and assigns to ______________________ all legal and beneficial right, title and interest in and to the within policy of insurance standing in my name and known as

Policy No. __________ issued by the ____________________ Insurance Company.

I also assign all cash values, proceeds and benefits thereto arising, subject to the conditions of said policy and the requirement of the issuing

underwriter: ____________________________

The undersigned warrants that it has full authority to transfer said policy, and shall execute all further documents as may be required by the underwriter.

This assignment shall be binding upon and inure to the benefit of the parties, their successors, assigns and personal representatives.

Signed this _______________________ day of _______________________, _____.


In the presence of:


____________________________
Witness

____________________________
Name

____________________________
Address

____________________________

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