Form Required 8/1; Revised Application Required 10/1

Model Replacement Form Required Aug. 1, 2017, Newly Revised MO Application required 10/1/2017

Effective August 1, 2017, the Model Replacement form (REPL-2000) is required to be completed and submitted with new business paperwork whenever a proposed insured states they have existing insurance coverage, even if they don’t plan on replacing that coverage.
The REPL-2000 replaces the existing Model Replacement form, form MO-R1.

This form is required for Individual Life and Annuity agents/producers; Missouri Preneed agents/producers are exempt from this change.

The MO application form 2735FE has also been revised to accommodate the State of Missouri’s Model Replacement requirement; a two-question Applicant Replacement section was added to the application directly below the Beneficiary Information section. While being updated with the Model Replacement section, the application also had a helpful secondary addressee row added.

  • Please use the new Model Replacement form (REPL-2000) by August 1, 2017.  This required Model Replacement form can be accessed using the above link, is included in application kits and is available on your Supplies site on It is recommended to also use the application as soon as possible.

There is a 60-day implementation period to switch out old applications with the new applications, but, beginning October 1, 2017, policy issuance will be delayed if the new application form is not used.

Please contact NGL’s dedicated Life Product Support team at 800-762-9883 or with questions.


>   Related: UPDATE: Form Required August 1, Model Replacement Form