Pacific Life Insurance Company fax number

Fax destination details

Department

Pension Risk Transfer (PRT) – Attorney-in-Fact

Purpose

Submit the Affidavit by Attorney In Fact form for Pension Risk Transfer Annuities; include the Power of Attorney and any riders/addendums.

Form

Affidavit – By Attorney In Fact — Affidavit – By Attorney In Fact

Address

PO Box 25189, Lehigh Valley, PA 18002-5189; Overnight Deliveries: Pacific Life, 1530 Valley Center Parkway, Bethlehem, PA 18017

Voice phone

Toll Free: (833) 702-1617

Website

Visit organization website

Before you send

• Confirm that this exact department handles your document or request.
• Check the organization website or call its main line for the current fax number.
• Include a cover sheet and any case, member, claim, or form reference required.
• Keep the delivery confirmation with your submission records.

Use this form to certify and agree to conditions and provide Attorney in Fact and Payee information. The form must be completed by the Attorney-in-Fact under the Power of Attorney and submitted with a full copy of the Power of Attorney and any applicable riders or addendums; any contingency documentation required by the Power of Attorney must also be submitted.

Official form instructions are published as a downloadable file on the organization's website.