Instructions

  • Please fill-in the form, download the filled-in form, print and sign the form, and then mail the signed form to:

    Woman’s Life Insurance Society®
    1338 Military Street
    PO Box 5020
    Port Huron, MI 48061-5020
A-15 Application for Change of Beneficiary

Primary Beneficiary Address 1

Primary Beneficiary Address 2

Primary Beneficiary Address 3

Primary Beneficiary Address 4

Primary Beneficiary Address 5

Contingent Beneficiary Address 1

Contingent Beneficiary Address 2

Contingent Beneficiary Address 3

Contingent Beneficiary Address 4

Application for Change of Beneficiary (A-15) Page 1

Class Beneficiary Address 1

Class Beneficiary Address 2

Class Beneficiary Address 3

Class Beneficiary Address 4

Class Beneficiary Address 5

Class Beneficiary Address 6

Application for Change of Beneficiary (A-15) Page 2