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Electronic Record and Signature Disclosure and Consent

Electronic Record and Signature Disclosure and Consent

From time to time, Amplify Life Insurance Company or its affiliates (collectively, “we”, “us”, or “Company”) may send you certain notices, agreements, acknowledgements, disclosures, or other documents including those which may be required by law (collectively, “Documents”). We may be required by law to provide those documents “in writing.” However, we may provide those documents electronically so long as you agree to these terms and conditions for providing to you such Documents electronically through the Company website, Company customer portal, or other electronic means. 

To continue with this electronic life insurance transaction process, including accepting electronic delivery of any notices and required disclosures, you must agree to this Electronic Record and Signature Disclosure and Consent (“Electronic Consent”), please confirm your agreement by proceeding with your estimate, including by providing us your email address and telephone number. By clicking the “See Your Results” button and/or retrieving an estimated premium you agree to this Electronic Consent.

Terms and Conditions

By agreeing to this Electronic Consent, you agree to all the following terms and conditions:

  • To conduct business with us electronically;
  • To receive electronic delivery of your application and insurance policy (if one is issued), as well as notices disclosures, authorizations, forms, and any other documents and written communications that are permitted by applicable law to be sent electronically; 
  • You have the ability to access, view, store, download and print Documents electronically as described below; and
  • You will notify us in writing of any changes to your email address or other contact information at

Getting Paper Copies

At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. If you wish for us to send you paper copies of any such documents, we will do so at no cost to you. You may request delivery of such copies by following the below procedures.

Withdrawing Your Consent

If you decide to receive Documents from us electronically, you may at any time change your mind and inform us that thereafter you want to receive required Documents in paper form.

Consequences of Changing Your Mind

If you elect to receive required Documents only in paper form, it may slow the speed at which we can complete certain steps in transactions and may delay any communications between us and you.   

How to Contact Amplify Life Insurance Company

You may contact us at to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive Documents electronically. A single or periodic request for a paper copy of certain Documents will not require withdrawal of consent.

Requesting Paper Copies from Amplify Life Insurance Company

To request delivery from us of paper copies of the Documents previously provided by us to you electronically and/or withdraw your consent to receive documents electronically, you must send an email to and in the body of such request you must state your email address, full name, mailing address, and telephone number.

Required Hardware and Software

To access and retain Documents, you must:

  1. Have access to a computer or device (such as a tablet or a smartphone) capable of running a current internet browser;
  2. Be able to view all documents through the use of Adobe Reader or similar software and be able to print all such documents;
  3. Have access to internet service and an email account that can be used to receive and access all Documents; and
  4. Be able to send and receive emails that contain hyperlinks to websites.

By proceeding with your estimate, including providing your email address and phone number and clicking the “See Your Results” button(s), you confirm that:

  1. You can access and read this Electronic Consent;
  2. You can print this Electronic Consent on paper, or save or send this Electronic Consent to a location where you can print it, for future reference and access; and
  3. Until or unless you notify the Company as described above, you consent to receive exclusively through electronic means all Documents that are required to be provided or made available to you by the Company during the course of your relationship with us.