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Get and Sign Allianz Certification of Attorney in Fact 2018-2022 Form
Use CAPITAL letters and black ink. If you need more room for information or signatures, make a copy of
the relevant page.
Helpful to Know
•Y
ou must also submit a copy of the POA documents naming
you the Attorney-in-Fact for the contract owner, as well as
copies of any supporting documents, along with this form.
• Each Attorney-in-Fact added to a contract must complete and
submit a separate form.
• For subsequent transactions or service requests, a new
Certification of Attorney-in-Fact...
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