Downloadable Forms & FAQs

.pdf files available for download

Downloadable Forms

 

To make things easier for everyone, we have included some of our forms in .pdf format for you to download.

These forms must be followed correctly and sent in to the home office. (709 Brighton Rd, Pittsburgh PA, 15233) Please do not fax or email.

Request for Change in Insurance Contract – This form has various sections. By downloading this from you can change your address, name, beneficiary, premium mode, and dividend options.

Branch Membership Transfer – The name of this form speaks for itself. This form gives you the ability to switch to a new branch.

Contract Service Request – This form has various uses, including withdrawal from non-qualified annuities, cash surrenders, assignment of ownership, request duplicate contract, and a miscellaneous section.

Electronic Transfer (Premium Payments) – By filling out this form you can automatically have your premium payments taken from a bank account.

Recommender Form – You can earn cash rewards when you refer new members to the WPA.

 

Frequently Asked Questions

We realize information regarding life insurance and annuities is not always easy to come by.  Here is a compiled list of some of the most frequently asked questions.

What if I lose my Certificate (Policy)?

If a policy is lost, the owner of the policy (also known as the “certificate”) can complete and return this form or send us a short letter, fax or email saying the policy is lost. Include the policy owner’s name, address, and telephone number, and the policy (certificate) number.

We will send you a Lost Policy Form, which you should complete, sign and return to the Home Office. Once we receive your Lost Policy Form, we will send a Duplicate Policy, which will replace your original policy.

Send your Note to:

William Penn Association
709 Brighton Road
Pittsburgh, PA 15233-1821
FAX: 1-412-231-8535
email: mail@wpalife.org

As Primary Beneficiary, if someone dies, what do I do?

If a member dies, send us a letter by certified mail telling us the insured has died. With this letter, enclose all WPA policies the insured owned, and a certified copy of the death certificate. You should be able to get a certified copy of the death certificate from the funeral home. In your letter, be sure to include your name, address and telephone number.

Any policy proceeds will be made payable to the primary beneficiary listed on each policy.

Write to us at:

William Penn Association
709 Brighton Road
Pittsburgh, PA 15233-1821
FAX: 1-412-231-8535
email: mail@wpalife.org

How do I change my Beneficiary?

To change the beneficiary, the policy owner should send us a short letter, fax or email requesting a change of beneficiary. Include the policy owner’s name, address, and telephone number, and the policy number.

We will send you a Request For Change In Insurance Contract (Policy) Form. You should complete and sign the form and return it to the Home Office for endorsement. Once we receive your form, we will change the beneficiary on your policy.

When filling out the new beneficiary information, please include the shares. A share is the fraction or percentage of your policy’s proceeds that each beneficiary is to receive.

You must include at least one primary beneficiary on the Change of Beneficiary Form. The primary beneficiary receives the policy’s proceeds. The primary beneficiary must be someone other than the insured.

Naming one or more contingent beneficiaries is not required, but we recommend it. The contingent beneficiary receives the policy’s proceeds if the primary beneficiary is deceased at the time a claim is made on the policy.

Shares are required. This is a percentage (or fraction) to be divided among your beneficiaries.

Send your Note to:

William Penn Association
709 Brighton Road
Pittsburgh, PA 15233-1821
FAX: 1-412-231-8535
email: mail@wpalife.org

We would like you to include your telephone number with your request in case we have any questions.
The form must be signed by you and a disinterested witness (The witness cannot be a Primary or Contingent Beneficiary). The original form must be mailed in to the Home Office address listed above.

What should I do if I move?

If you move, the policy owner should send us a short letter, fax or email telling us of the move. Include the policy owner’s name, old address, new address, old and new telephone numbers, and the certificate numbers of all policies owned by that person.

We will update our records as soon as possible.

Send your Note to:

William Penn Association
709 Brighton Road
Pittsburgh, PA 15233-1821
FAX: 1-412-231-8535
email: mail@wpalife.org

I did not receive a Premium Due Notice (or it was lost), what do I do?

If you did not receive a premium due notice (or it was lost), the policy owner should send a short letter, fax or email telling us the premium due notice was not received (or was lost). Include the policy owner’s name, address, and telephone number, and the certificate number of the policy in question.

We will research our records and inform you of the status of your policy. If premiums are due, we will send you a duplicate premium due notice.

Send your Note to:

William Penn Association
709 Brighton Road
Pittsburgh, PA 15233-1821
FAX: 1-412-231-8535
email: mail@wpalife.org

How do I change my Name on my policy?

To change your name on your policy, the policy owner should send us a short letter, fax or email requesting the name change. Include the policy owner’s original name, new name, address, and telephone number, and all certificate numbers of policies owned by that person.

We will send you a Request For Change In Insurance Contract (Policy) Form. You should complete and sign this form and return it to our Home Office along with your policy.

Once we receive your form, we will update our records and make the change directly on your policy. We will then return your policy to you.

Send your Note to:

William Penn Association
709 Brighton Road
Pittsburgh, PA 15233-1821
FAX: 1-412-231-8535
email: mail@wpalife.org

We would like you to include your telephone number with your request in case we have any questions.

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