Use this form to make a loan repayment or submit additional premium on your policy. The policy number is required along with the amount being submitted.
The form can be completed online, then printed and signed. Click the link below and the form will open in a new window. Once completed and printed, clear the form and/or close the window.
You may mail or deliver the signed and witnessed form to your agent or to the address below:
Farm Bureau Life Insurance Company of Michigan
7373 W. Saginaw Hwy., PO Box 30200
Lansing, MI 48909-7700
Loan Repayment Form