Neptune-Administered Forms for Minnesota

The below forms are specific to this state. Non-state specific forms can be located on the General Forms page.

Administration Back To Top

.  06670220-1183USLMN Master Application MN

Claims Back To Top

There are no state-specific forms. Use forms located on the General Forms page.

Group Statement of Insurability Back To Top

American General Life Insurance Company of Delaware

.06673571-1005USLMN Statement of Insurability for Group Programs MN

Voluntary Statement of Insurability Back To Top

The United States Life Insurance Company

.00305101-1098USLMN Application for Group Voluntary Programs All Coverages MN

American General Life Insurance Company of Delaware

.06673571-1098USLMN Application for Group Voluntary Programs All Coverages MN
.06673571-1496USLMN Application for Group Voluntary Programs Life & AD&D Only MN