Description. Assigns all interest and benefit in the attached Statement of Account ("the Account") to Assignee. A statement of funeral goods and services selected for the deceased is attached hereto. Beneficiary. (Signature).With SRS E-Pay Insurance Assignments, enter numerous policies directly from a case using the data you've already entered for the deceased, family, and invoice. The following Homesteaders Life Company insurance service forms are available in PDF format. Please select the appropriate form, print and complete. This form will go directly to the National Care Planning Council and not to a specific person or company.