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STOCK ASSIGNMENT FORM - Aflac

TRANSFER SHARES FROM THE FOLLOWING ACCOUNT Print registered owner(s) information as it appears on the statement or STOCK certificate. If deceased, print name(s) and information of the deceased as currently appears on the statement or STOCK certificate. Account Number: Account Name: Address: SSN/Tax ID: Phone Number: TRANSFER INSTRUCTIONS TO EXISTING OR NEW ACCOUNT Aflac Incorporated is a paperless legals agent (PLA) and is DRS-eligible.

TRANSFER SHARES FROM THE FOLLOWING ACCOUNT Print registered owner(s) information as it appears on the statement or stock certificate. If deceased, print …

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