American Income Life Insurance Company Vendor Disbursements

Vendor Information

Please enter a valid Vendor Name.
Please enter a valid Country.
Please enter a valid Vendor Number.
Please enter a valid Tax ID Number.
Please enter a valid Address.
Please enter a valid City.
Please enter a valid State/Province.
Please enter a valid Zip/Postal code.

Bank Information

Please enter a valid Name of Account.
Please enter a valid Bank Name.
Please enter a valid Account Type.
Please enter a valid Routing Number.
Please enter a valid Bank Transit Number.
Please enter a valid Branch Name.
Please enter a valid Account Number.
Account Number must match.
  • A PDF copy of a voided check
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  • PDF copy of a printed account verification screen signed and stamped with the bank stamp
  • A PDF bank statement
  • A PDF copy of screen shot from a Mobile Bank device
Only PDF files are currently supported.

By clicking “submit” I authorize American Income Life Insurance Company to deposit payments to my financial institution electronically. I understand that American Income Life Insurance Company will reverse any payments made to my account in error.

By clicking submit, I authorize American Income Life Insurance Company to deposit funds directly in to my specified account. If the company erroneously deposits funds in to my account, I authorize the company to initiate the necessary debit entries not to exceed the total of the original amount credited to my account. I understand that this authorization will remain in full force and effect until I notify the company in writing that I wish to revoke this authorization in such a time and manner as to afford the company a reasonable opportunity to act on such request.

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