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Get Fidelity Security Life Insurance Company

Anapolis, IN 46207-7106 1-800-553-3522 Fax 317-285-7666 www.employeebenefits.aul.com This form is to be completed by the Employer/Policyholder Instructions Please read carefully and submit all required information. 1) Proof of Death must be furnished without expense to American United Life Insurance Company (AUL). Each question must be answered completely, accurately, and truthfully. AUL reserves the right to obtain further information when necessary. 2) A certified death certificate is.

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