PALIC

New Contract Registration

Please provide your Contract information:

Contract Number: *

Insured's Name: *

Date of Birth: *

Current Policy Face Value: *

Policy Date: *

Country Of Residence at Issue:

If you encounter problems after attempting to register your policy, please contact us at 1-877-939-4550 or service@palig.com. If calling from Guatemala, please dial 1-866-295-5670.