Printable Forms For Current Structured Settlements Customer
If you currently receive benefits from Liberty Life Assurance Company of Boston Structured Settlements, and you wish to:
  • Convert your payments from paper check to Electronic Funds Transfer (EFT).
  • Update/Change the checking or savings account information on your existing EFT agreement.
  • Request a change of name and/or address.
  • Designate/Change your beneficiary.
  • Provide authorization for a third party to obtain information related to payments due to you.
Please print and complete the appropriate form below (Adobe Acrobat Reader required) and return it to the address or fax number stated on the form.
You may also scan the completed form and email to**

**Please note we require up to five business days for processing from receipt

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Liberty Life Structured Settlements FAQs