Change
of Purchaser Due to Death Form
-
- If no Successor Purchaser was named on the contract, complete all sections of this form and attach a copy of the death certificate and the appropriate pages from the Will giving evidence of appointment as executor, or letters of testamentary.
- Questions should be directed to Customer Service at our toll-free number, 1-877-877-3724, option 2.
- Submit by mail to College Illinois!, P.O. Box 19292, Springfield, IL 62794-9292 or by fax to 1-800-519-4652. Written confirmation will be sent when the change has been processed.
Current Contact Information - Please print legibly
| College Illinois! Account Number: | ___________________________________________________________________________ |
| Current Purchaser Name: | ___________________________________________________________________________ |
| Current Beneficiary Name: | ___________________________________________________________________________ |
New PurchaserInformation - Please print legibly
| Name (First, Middle, Last, Suffix): | ___________________________________________________________________________ |
| Social Security Number: | ___________________________________________________________________________ |
| Street Address / PO Box / Apt. #: | ___________________________________________________________________________ |
| City, State, Zip: | ___________________________________________________________________________ |
| Email Address: | ___________________________________________________________________________ |
| Telephone Numbers: | Home:________________________________Work:__________________________________ |
| _________________________________________________________________________________________________________ | ||
| New Purchaser's Signature | Date | |
| _________________________________________________________________________________________________________ | |
| Executor Signature | Date |