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Private Split Dollar Submission Guidelines

Take advantage of complimentary, administrative services from The Principal by making sure your business is submitted to our Business Market Administration (BMA) department.


  1. Complete life insurance applications and accompanying life insurance illustration(s), per NAIC regulations.
    • An irrevocable life insurance trust (ILIT) will be the policy owner and beneficiary.
    • Typically, the policy will be collaterally assigned to the sponsor/premium payor using a limited (restrictive) collateral assignment.
    • Sex distinct rates apply.
    • To obtain life insurance applications, visit the Create Application Packet page in Virtual Supply, or Principal Advisor Network offices may use Life E-App (for Term and Universal Life products only).
  1. Have customer complete a Private Split Dollar Agreement. Refer to these sample documents:

If applicable for the case, have client complete a Split Dollar Restrictive Collateral Assignment form (DD9215).

Submit the above completed documents.

  1. If trust-owned, submit Trust Certification and Indemnification form RF 971.
  2. Complete Private Split Dollar Submission Checklist (DD849P).
  3. Prepare a cover letter/memo if there are any special instructions or requests.
  4. Submit via fax or mail using the information in Contact Us below.

Important Information

Insurance issued by Principal National Life Insurance Co. (except in NY) and Principal Life Insurance Co. Plan administrative services offered by Principal Life. Principal National  and Principal Life are members of the Principal Financial Group®, Des Moines, IA 50392.


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