Electronic signature forms
Interested in the convenience of electronic form submission? Give it a try here.
Voluntary benefits forms
Bank Draft Authorization | Form L-5562
Provide Unum with your bank account information and authorize us to transfer funds on your behalf. To expedite the process, have a check on hand.
Third Party Authorization | Form CS-1178
Authorize Unum to provide details about your policy to individuals or organizations you designate.
Removal of Dependent Child | Form CS-1182
Remove dependent children from your policy or policies.
Policy Cancellation | Form L-52490
Complete this form to request cancellation of your policy or policies.
Beneficiary Change | Form L-52490
Update your primary and/or contingent beneficiaries on your policy or policies.
Name Change | Form L-52490
Request a name change on your policy or policies by completing this form. Legal documentation is required unless due to marriage or divorce.
Request Additional Change | Form L-52490
Use this form to request changes to your policy or policies, such as a decrease in benefit amounts, request for conversion of rider to a stand-alone policy, or other changes.