Service Forms

Use this form to request medical expense reimbursement following severance from employment.

For changing the contribution amount of future payments, changing employer information and applying to make contributions automatically via Electronic Funds Transfer (EFT). Note: This is not the proper form to use to transfer funds.

Use this form to request periodic exchanges from one investment option to one or more investment options. Complete the entire form.

Use this form to request periodic exchanges from one investment option to one or more investment options.

Use this form to request periodic exchanges from one investment option to one or more investment options.

Use this form to request periodic exchanges from one investment option to one or more investment options. Dollar Cost Averaging is subject to the provisions of your Contract and the current Prospectus. Complete the entire form.

Use this form to request periodic exchanges from one investment option to one or more investment options. Dollar Cost Averaging is subject to the provisions of your Contract and the current Prospectus. Complete the entire form.

Use this form to activate or update electronic banking.

For establishing the privilege to make changes to your contract via telephone. With this option you can submit an exchange between funds and change your future allocations.

Use this form to change employee status. Complete this form and enclose it with your payroll for any new employees not listed or terminated since the last contribution list.