2. The sole right to surrender the policy and receive the surrender value thereof at any time provided by the terms of the policy, and at such other times as the Insurer may allow.
Owner/Assignee Information Insurer GBU Financial Life Owner’s Legal Name (First, Middle Initial, Last) Assignee’s Legal Name (First, Middle Initial, Last) Assignee Address (Street, City, State, Zip) Policy Number EIN A. For value received, you, the policy owner hereby assigns, transfers and sets over to the Assignee (a financial institution organized and existing under the law with a principal office located at the address listed above) and to its successors the policy number listed above. This includes all claims, options, privileges, rights, title and interest in the policy (except as provided in Paragraph C below). This assignment is subject to all terms and conditions of the policy and to all superior loans, liens and claims, if any, that the Insurer may have accepted against the Thispolicy.assignment is made, and the policy is to be held as collateral security for any and all loans either now existing or that may arise hereafter between you and the Assignee (all of which loans are herein called “Liabilities”).
5. The sole right to exercise all non forfeiture rights permitted by the terms of the policy or allowed by the Insurer to receive all benefits and advantages derived therefrom.
Collateral Assignment of Life Insurance
The undersigned jointly and severally agree and the Assignee, by acceptance of this assignment, agrees to the conditions and provisions herein set forth.
4. The sole right to collect and receive all distributions, dividends or additions to the policy, now or hereinafter made or apportioned thereto, and to exercise any and all options contained in the policy.
The Assignee can exercise any right, option, privilege or power given herein without notifying you or seeking permission from you. GBU FINANCIAL LIFE service@gbu.org PO Box 645949 Pittsburgh, PA 15264 5257
B. Rights that transfer to the Assignee: It is expressly agreed that the following specific rights are included in this assignment and pass by virtue hereof to the Assignee:
1. The sole right to collect net proceeds from the policy when it becomes a claim by death or maturity.
412 884 5100 800 765 4428 GBU CAL-Form 0321 1
3. The sole right to obtain advances on the policy, and to pledge or assign the policy as security for such advances.
E. The Insurer will recognize the rights of the Assignee: The Insurer is hereby authorized to recognize the Assignee’s claims to rights hereunder without investigating the reason for any action taken by the Assignee, or the validity or the amount of the Liabilities or the existence of any default therein, or amounts to be paid to the Assignee. The sole signature of an officer of the Assignee shall be sufficient to exercise the Assignee’s rights hereunder.
1. The right to designate and change the beneficiary.
2. The Assignee will not exercise either the right to surrender the policy or the right to obtain policy loans from the Insurer, until there has been default in one or more of the Liabilities or a failure to pay any Policy premium when due.
C. Rights that do not transfer to the Assignee: It is expressly agreed that the following specific rights, so long as the policy has not been surrendered, are reserved and excluded from this assignment and do not pass by virtue hereof:
D. Payout conditions: The Assignee agrees with the undersigned as follows:
F. Payment of premiums into the policy: You are responsible for continuing to pay any premiums or other charges under the policy. If the Assignee must pay any of these amounts out of its own funds, any such amounts shall become part of the Liabilities secured hereunder.
Collateral Assignment of Life Insurance (continued) GBU CAL-Form 0321 2
G. The exercise of any right, option, privilege or power given herein to the Assignee shall be at the option of the Assignee and may be exercised without notice to, or assent by, or affecting the liability of, or releasing any interest hereby assigned by, the undersigned, collectively or individually.
H. The Assignee may take or release any other security, may release any party primarily or secondarily liable for any of the Liabilities, may grant extensions, renewals or indulgences with respect to the Liabilities, or may apply to the Liabilities in such order as the Assignee shall determine, the proceeds of the policy hereby assigned or any amount received on account of the policy by the exercise of any right permitted under this assignment, with regard to other security.
I. Tax Status: This information is provided as a general guidance. It is not intended to be legal or tax advice. You should contact your legal and/or tax advisor regarding your personal facts and circumstances and the applicability of the issues described herein.
2. The right to elect any optional mode of settlement permitted by the policy or allowed by the Insurer. The reservation of these rights shall in no way impair the right of the Assignee to surrender the policy completely, or impair any other right of the Assignee hereunder. Any designation, change of beneficiary or election of a mode of settlement shall be made subject to this assignment and to the rights of the Assignee here under.
1. Any balance remaining under the policy after payment of the then existing Liabilities of the undersigned, shall be paid by the Assignee to the persons entitled thereto under the terms of the policy had this assignment not been made.
Collateral Assignment of Life Insurance (continued) GBU CAL-Form 0321 3 J. Conflicts: In the event of any conflicts between the provisions of this agreement and/or the provisions of the note or other evidence of any Liability, the provisions of this assignment will prevail. K. Bankruptcy: By signing this document, you declare that no proceedings in bankruptcy are pending against you and that your property is not subject to any assignment for the benefit of Executedcreditors.this day of , 20 , at , _ Owner WitnessSignatureSignature Subscribed and sworn to before me this day of , 20 Notary , __ County State My commission expires _ The aforementioned Insurer hereby agrees to the terms and conditions of this assignment and will notify the Assignee of any default which may cause termination of this policy. Duplicate received and filed at the G BU Financial Life Home Office in Pittsburgh, PA, this day of , 20 By _ Title _ _
