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Clear Spring Life and Annuity Company fax number

(317) 574-2050

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Release of Information

Used for: Release of Information (ROI) requests and revocations submitted by fax

Fax destination details

Department
Release of Information
Purpose
Release of Information (ROI) requests and revocations submitted by fax
Form
Release of Information form — Authorization for Release of Information/Revocation of authorization for Release of Information
Address
10555 Group 1001 Way, Zionsville, IN 46077; Mailing: P.O. Box 80509, Indianapolis, IN 46280-0428
Voice phone
800-990-7626

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Complete contract owner information, specify the recipient, sign and date; submit to the company to authorize release of information about contracts

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