Life Insurance Forms

Online service forms for your convenience

life insurance forms being signed
Find the service form you need from the list below. Complete, sign and date forms and return to Liberty Life for processing.

Liberty Life Assurance Company of Boston
Service Center - MS 03B
100 Liberty Way
Dover, NH 03820

Fax: 1-603-749-9759

Or, you can scan a copy of the completed form and email to:


For information regarding your coverage, beneficiaries, loans or contract credits/dividend options, please contact Policyholder Services at 1-800-451-7065 Monday through Friday, 8:00 a.m. to 6:00 p.m. Eastern Time.

Life insurance products offered through Helmsman Insurance Agency, LLC, 175 Berkeley Street, Boston MA 02116