Address Change Form

It is very important that we have your current mailing address, email and phone number. Make sure that when you move you keep PFSA updated with your current contact information. Moving can be both exciting and overwhelming.

Change of Beneficiary Form

Use this form to add or change the beneficiary/ies on your PFSA life insurance policies or financial accounts. The form requires a Notarized signature.

Change of Name Form

You may eliminate lots of frustration by making sure that your policy is up to date, especially when life events take place. If your name has changed because you recently got married, due to a divorce or adoption, you will need to make sure that your PFSA policy/ies or accounts are up to date. This will take a few minutes of your time.

EFT Payment Authorization Form

Schedule your payment to be automatically deducted from your checking or savings account. Just complete and sign this form to get started! Recurring Payments Will Make Your Life Easier:

• It’s convenient (saving you time and postage)
• Your payment is always on time (even if you’re out of town), eliminating late charges

Lost Policy Form

If you have misplaced your PFSA Life Insurance contract or Annuity Contract, download the Affidavit of Lost policy to request a duplicate copy of your contract. This form requires a Notarized signature.

Fraternal Council Transfer Form

This form is to be used when changing your membership to another council. If you recently moved and would like to participate in the local council close to your new residence, request a transfer of membership. Get involved with your council and help make a change in your community.