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Manage your PRCUA certificate

The following forms are available online to manage your membership certificates:

  • A005 (Non-Qualified Annuity Deposit Agreement Distribution Request)
  • A008-CB792 (Beneficiary Designation – Change of Name)
  • A010 (IRA Distribution Request)
  • A012-1048 (Affidavit in Case of Loss or Destruction of a Certificate)
  • A012-1048-SUR (Affidavit in Case of Loss or Destruction of a Certificate for Surrenders)
  • A014 (Authorization to Disclose Annuity Account Information + FAQs)
  • A100 (IRA Required Minimum Distribution (RMD)
  • A1025 (Change of Address Form)
  • A1095 (Proof of Heirship)
  • A1109 (Affidavit in Case of Loss or Destruction of Deceased Member’s Certificate)
  • A3790 (Beneficiary Change to Trustee)
  • ACH (ACH Authorization)
  • GO19 (Death Benefit Claim Form)
  • GO20 (Cash Surrender Request Form)
  • W-9 (Request for Taxpayer Identification Number)

***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.

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OUR MISSION

PRCUALife is a fraternal benefit society providing financial security to its members through life insurance and annuity products, and offering opportunities for cultural, educational and spiritual growth.

Naród Polski Archive

As part of our green strategy, the PRCUA offers digital versions of the Naród Polski publication in a graphical, highly readable, and environmentally friendly non-tree-based PDF format.

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Polish Roman Catholic Union
  • News
    ▼
    • PRCUA Calendar of Events
    • Financial Blog
    • Naród Polski
    • Photo Galleries
    • Media
  • About Us
    ▼
    • Mission
    • National Officers and Directors
    • History
  • Membership
    ▲
    • How to Join
    • Member Loans
    • Newborn Children and Orphans
    • PerkSpot Discount Program
    • Prescription Discount Programs
    • PRCUA Scholarships
    • Manage your PRCUA certificate
    • Make a Payment
  • Fraternal Programs
    ▼
    • Language & Dance Programs
    • Sports Programs
  • Products
    ▼
    • Annuities
    • Life Insurance Plans
    • Member Loans
    • Make a Payment
  • Contact Us
    ▼
    • Home Office
    • Locate an Agent
    • PRCUA Societies Online
  • Agent Portal