Printable Forms

Members may make a variety of changes- including change of address, name of insured, owner, Payor, etc., change of premium mode and/or amount, branch transfer, certificate withdrawal, dividend withdrawal, premium deposit fund withdrawal, certificate loan, and surrender, and many more- simply by completing one of the following forms.

Mail, fax, or email the completed form to:

Catholic Life Insurance
Attn: Membership Service Center
P.O. Box 659527
San Antonio, Texas 78265-9527.

Fax: (210) 828-4629

Email: mscenter@cliu.com

Life Transaction Form

Members may use this form for the following transactions on life certificates (Whole Life, Term Life, Universal Life, Ordinary Life, etc.):

  • Change the address, telephone, or email address of the Insured, Owner, Payor, Beneficiary, or Assignee
  • Make certificate changes, request transactions, or other requests

Life Transaction Form

Annuity Transaction Form

Members may use this form for the following transactions on annuity certificates (Traditional IRA, SEP-IRA, Roth IRA, Non-Qualified Annuity, Trust/Endowment Annuity, etc.):

  • Change the address, telephone, or email address of the Annuitant, Owner, Payor, Beneficiary, or Assignee
  • Make certificate changes, request transactions, or other requests
  • If you are requesting a taxable transaction, you will also need to submit a completed IRS Form W-4R
    • You can request this form from our Membership Service Center or find it on the IRS.gov website

Annuity Transaction Form

Name Change Form

Members may use this form if there is a change to the name of the Insured/Annuitant Owner, Payor, Beneficiary, or Assignee.

  • Example: Barbara M. Doe is now Barbara D. Smith because of marriage
  • This form must be accompanied by supporting documentation for the requested change.

Name Change Form

Premium Transaction Form

Members may use this form to change their premium method or frequency.

  • You can change the address, telephone, or email address of the Payor
  • If you are requesting to begin the bank draft, you will also need to submit a completed Bank Draft Authorization Form

Premium Transaction Form

Change of Owner or Beneficiary Form

Members may submit a change of owner or beneficiary by completing this form:

Change of Owner or Beneficiary Form

Notice of Death Form

Members may submit a notice of death by completing this form:

Notice of Death Form

Bank Draft Form

Paying your life insurance/annuity premium by bank draft is the simplest way to ensure that we receive your payment on time.

Bank Draft Form

P.O Box 659527 San Antonio, TX 78265-9527 (800) 262-2548
© 2023 Catholic Life Insurance