Notice Of Data Event

Bank Authorization Form (MYGA)

See all:

Employer Resources
Individuals & Families Resources


This is our MYGA Bank Authorization Form. This form is used to establish or change a bank account to make and/or receive payment for policies and contracts.

Bank Authorization Form (MYGA)

Download & Print


Using a blue or black ink pen

Submit in 1 of 3 Ways

Email: [email protected]

Fax: 1 (808) 942-1295

or Mail:
Pacific Guardian Life
Attn: Client Relations Department
1440 Kapiolani Blvd.,
Suite 1700
Honolulu, HI 96814