Manage your PRCUA certificate

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

***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 (which can be found below), along with a Request for Taxpayer Identification Number W-9 form must also be submitted.***

The following forms are download-only. These forms are provided in Adobe® Acrobat® format. Please fill out the digital form, save and click here to upload.

A008-CB792 Change of Beneficiary – Change of Name

A012-1048 Affidavit in Case of Loss or Destruction of a Certificate

A1109 Affidavit in Case of Loss or Destruction of Deceased Member’s Certificate

A3790 Beneficiary Change to Trustee

ACH1 – ACH Authorization

Alternatively, you may print and mail the completed form to our main office:

Polish Roman Catholic Union of America
Attn: Member Services
984 N. Milwaukee Ave.
Chicago, IL 60642-4101

If you have any questions please contact us online or call 1-800-772-8632