Equity Redemption Paperwork Request- Estate/ Deceased Patron Equity Redemption Paperwork Request- Estate/ Deceased Patron Estate payouts are processed once per quarter. They are voted on after the quarterly board of directors meeting. There are no exceptions. For any additional questions, please contact EquityInfo@ALCIVIA.com or call 608.819.3102. Deceased Patron Name * Deceased Patron Name First First Last Last Deceased Patron Account Number(s) If there are multiple account numbers, separate with a comma Contact Name * Contact Name First First Last Last Customer would like paperwork via: * Email Physical Mail Email Address * Phone Number * Contact Relation to the Deceased: * Child Spouse Personal rep Other Contact Mailing Address * Contact Mailing Address Contact Mailing Address Contact Mailing Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Will someone continue to utilize the account? * Yes No Death Certificate File Upload Drop a file here or click to upload Choose File Maximum file size: 157.29MB Please add any additional comments or notes about this request If you are human, leave this field blank. Submit Start Over
