Establishing a New Attorney-In-Fact
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This form serves as an agreement between Pacific Guardian Life Insurance Co. Ltd. (PGL) and the Attorney in Fact (AIF).
If you are a now servicing AIF for a springing Power of Attorney or a successor AIF, you must also include a letter from a doctor or hospital administrator on their letterhead as proof of the principal’s incapacitation.
Before completing this form, please know that this form is not to be used:
Download & Print
Complete
Using a blue or black ink pen
Submit in 1 of 3 Ways
Email: [email protected]
Fax: 1 (800) 946-1295
or Mail:
Pacific Guardian Life
Attn: Client Relations Department
1440 Kapiolani Blvd.,
Suite 1700
Honolulu, HI 96814