Report of Insured's Death

To inform Northwestern Mutual of a death of your loved one, please complete the following form.
We will be in contact with you shortly.

Deceased's Personal Information
All fields marked with * are required
* Name
Date of Birth (mm/dd/yyyy)
* Policy Number(s)

separated by commas
Cause of Death
* Date of Death (mm/dd/yyyy)
* Address
* City, State, Zip
* Place of Death
Other Policy Numbers Owned by Deceased

separated by commas
Notification Completed By
* Name
Relationship to Insured
* Address
* City, State, Zip
* Home Phone Number
Email

If you have any questions, call us at (800) 388-8123, between 7:00 AM and 6:00 PM CST.

90-1323-01 (INT)