The following forms are required for processing your initial and/or subsequent funding claims. You will need the free Adobe Acrobat Reader to open these forms. If you don't already have the reader installed, you can download it here.

Steps to complete forms:

  • Right-click the required form link(s) below
  • Select "Save As" or "Save Link As" from the popup window
  • Save the form to your hard drive for current and future use
  • Navigate and open the form
  • Complete the form in Acrobat and save the form
  • Print the form and sign by hand in black ink as indicated
  • Fax the printed form to 866-554-0262 or scan and email to:
New Account Set up Form
This form is to be completed in order to be set up as a new customer for Bravura Finance. This will provide us with all your basic information. The form only needs to be submitted once unless you need to update your information.

Request For Funding Immediate Insurance Verification Form
This form will provide us with basic information on the specific funding amount, deceased, beneficiary and policy.

Irrevocable Assignment and Power of Attorney
This required form will allow the policy amount submitted to be assigned and/or reassigned to Bravura Finance from the beneficiary.

Note: There are three slight variations of the form to choose from.  Select the one that suits your needs best

Insurance Policy Claim Form:
These will be sent directly from Bravura Finance to you. Most insurance companies have their own policy claim form.

The forms listed here can also be obtained by contacting Bravura Finance directly via email or by calling: 317-830-8147.
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