Disability Income Protection

Agent Forms

To Obtain Forms: Please Contact Our Office At 1-800-437-1670 or Email A Request to Allotment@toweradmin.com


You will be creating an original form. Complete the form(s) with the required information (Please print clearly) and employee's signature. Make a copy for your records, and send the original to Tower for processing. If you fax your forms to Tower, you may keep the original for your records.

Attention Agents: Helpful Hints for completing your paperwork!


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Click here to download.


Tower Insurance Services, Inc.  8 Marticville Road, Lancaster PA 17603
Phone (800) 437-1670  Fax (717) 872-0623
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