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Summary: This is a Non-USA Citizen Questionnaire from iA American Life Insurance Company, used by WFG agents during the underwriting process for non-US citizen life insurance applicants.
It collects basic identifying information (name, policy number, ITIN, country of birth/citizenship) and asks six questions to verify the applicant’s US ties — including residency history, employment, a US address, and established US medical care.
The applicant must sign a declaration of truthfulness and also complete IRS Form 4506T as part of the submission.