Life Insurance Policy by zwi14607


									                                                  Life insurance policy.

    For $       , and for other valuable considerations (the receipt of which is acknowledged) I assign, transfer and set
over Policy No.         on the life of        issued by the [insurance company] with all rights in the policy, and with all
money now or in the future due or payable on the policy, and all dividends, options, benefits or advantages derived from
the policy, including the right to surrender the policy at any time and to receive and receipt for the surrender value of the
policy to         whose address is         .

    For the consideration expressed above I do also for my executors and administrators, guarantee the validity and
sufficiency of this assignment to the named assignee his [her] executors, administrators and assigns; and their title to the
policy will forever warrant and defend.

   Witness my hand and seal.

                                                                                                       [Date and signature]

                                                  Consent to Assignment

   [insurance company] consents to indorsement and assignment of the policy.

   Dated         , at [city, county, state].


                                                                                                               electronic form 2005
                                                                                                               Law Publishers

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