The following forms are available online to manage your membership certificates:
LIFE INSURANCE
CURRENT LIFE INSURANCE OWNER
Authorization Disclosure:
Make a change to a certificate:
- A008-CB792 (Beneficiary Designation – Change of Name)
- A3790 (Beneficiary Change to Trustee)
- A1025 (Change of Address Form)
Certificate replacement request:
Cash Surrender:
- GO20 (Cash Surrender Request Form)
- A012-1048-SUR (Affidavit in Case of Loss or Destruction of a Certificate for Surrenders)
- ACH (ACH Authorization)
- W-9 (Request for Taxpayer Identification Number)
BENEFICIARY OF A LIFE INSURANCE CERTIFICATE
- GO19 (Death Benefit Claim Form)
- A1095 (Proof of Heirship- to be used when all named beneficiaries are deceased)
- A1109 (Affidavit in Case of Loss or Destruction of Deceased Member’s Certificate)
- ACH (ACH Authorization)
- W-9 (Request for Taxpayer Identification Number)
ANNUITIES
CURRENT ANNUITY OWNER
Authorization Disclosure:
Certificate replacement request:
Make a change to a certificate:
- A008-CB792 (Beneficiary Designation – Change of Name)
- A3790 (Beneficiary Change to Trustee)
- A1025 (Change of Address Form)
Request for a distribution:
- A005 (Non-Qualified Annuity Deposit Agreement Distribution Request)
- A010 (IRA Distribution Request)
- A100 (IRA Required Minimum Distribution (RMD)
- ACH (ACH Authorization)
- W-9 (Request for Taxpayer Identification Number)
Surrender (Close) Annuity:
- GO20 (Cash Surrender Request Form)
- A005 (Non-Qualified Annuity Deposit Agreement Distribution Request)
- A010 (IRA Distribution Request)
- A012-1048-SUR (Affidavit in Case of Loss or Destruction of a Certificate for Surrenders)
- ACH (ACH Authorization)
- W-9 (Request for Taxpayer Identification Number)
BENEFICIARY OF AN ANNUITY CERTIFICATE:
- GO19 (Death Benefit Claim Form)
- W-9 (Request for Taxpayer Identification Number)
- A1109 (Affidavit in Case of Loss or Destruction of Deceased Member’s Certificate)
- ACH (ACH Authorization)
***Please be advised – when surrendering an annuity for a lump sum distribution, the original annuity certificate or Affidavit in Case of Loss or Destruction of a Certificate, along with an IRS W-9 form must also be submitted (the links for these forms are available above).
If you have any questions please contact us online or call 1-800-772-8632.