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APPLICATION
Premium with the Application

We encourage you to collect the first premium with the application, except when:

  1. Proposed insured has been rated or declined in the past.
  2. Proposed insured has significant medical problems (see Common Ratable Impairments section or call the underwriter with any questions).
  3. Either of the temporary life insurance questions on the Part I application is "Yes."
  4. The total amount applied for on all current applications to Symetra Life exceeds $1,000,000.
  5. It is a No Cash 1035 Exchange.

Please send owner/applicant checks only, made payable to Symetra. All refunds are mailed directly to the applicant.

Initial Payment by Bank Draft (EFT)
If your client would prefer to pay premiums by Bank Draft (EFT), please complete the Initial Payment by Bank Draft (EFT), form LA-4030 and submit with the application.

Please be sure the information on the form is accurate and that the client understands that their account will be drafted for the initial premium as soon as we issue the policy.

  1. Remind your client to deduct the initial payment from their checking or savings account register immediately. The initial payment will be drafted when the policy is put in forced (issued). Subsequent premiums will be deducted each month on the selected draft date.
  2. Attach a voided check or deposit slip from the account to be drafted or complete the account information section on the Initial Payment by Bank Draft, form LA-4030.
  3. Indicate the draft date on the EFT form.
  4. Have the applicant sign the form.
  5. Send the completed EFT form with the application. If you are submitting the EFT form separately, fax it to 1-877-435-5500.