Service & Forms

Download common forms and find out about various departments at GBU that you may need to speak with about your policy.

IMPORTANT NOTE: ANNUAL STATEMENTS ARE NOW AVAILABLE ON THE MEMBER PORTAL AND ARE EXPECTED TO BE DELIVERED VIA MAIL THE LAST WEEK IN JANUARY. 1099 FORMS FOR MEMBERS WILL BE AVAILABLE MID-TO LATE-FEBRUARY.

COMMON FORMS

For policy changes and related services, please download, print and complete the proper form. For your convenience you may email the completed form to GBU via our secure message center or mail your completed form to the GBU Home Office. Confirmation of the service provided will be mailed to the policy owner upon completion of the service requested.

All forms listed below are in Adobe PDF format. To download a form for viewing and printing, please click on the desired form. If you cannot find the form you need, or if you have questions relating to your GBU policy, please contact the GBU Home Office.

Important note about Microsoft Edge and fillable forms. If you are using Microsoft Edge for your internet browser, it does not recognize fillable forms and the form will not display in your browser. To get the form, right click on the link and choose "save target as" and this will allow you to save the form to your computer.

Accelerated Living Benefits Claim Form Annuitization Form Annuity Withdrawal Request Form Bank Draft Authorization Form Beneficiary Change Form Direct Deposit Authorization Form Life Insurance Death Claim Kit Lost Policy Form Non-Qualified Annuity Death Claim Policy Owner Service Request Form Qualified Annuity Death Claim Required Minimum Distribution Service Request Form Roth IRA Conversion Form

Member Portal Set-Up Instructions W-4P Form (download most recent version here) W-9 Form (download most recent version here) High School Grant Application

College Scholarship Application New England Fraternal Alliance Scholarship Pennsylvania Fraternal Alliance Scholarship Ohio Fraternal Alliance Scholarship District 2000 Scholarship Youth 3 Pay Membership Brochure With Pricing

Amended National Bylaws, 2021

Start a Claim Current Annuity Rates 2022 Financial Report

WHO DO I NEED TO TALK TO?

Here are the departments within GBU that you may need to assist you with your policy or membership. You can speak with a member in any of our departments by calling 800-765-4428.

Request An Appointment

Customer Service Department

This department is responsible for communication and coordination with GBU members and/or their beneficiaries with regard to life insurance policies and annuity contracts.

Contracting and Compliance

This department is responsible for regulatory compliance and contracts.

Underwriting Department

This department is responsible for processing submitted life insurance and annuity applications.

Sales Department

This department is responsible for the sale of GBU life insurance and annuity products.

Claims Department

This department is responsible for opening and administering life insurance claims.

Fraternal Department

This department is responsible for administrating
member benefits offered by GBU.

This department also communicates and coordinates with GBU districts.

SEND A SECURE EMAIL

The protection and privacy of your communications with GBU is very important to us. To ensure your information remains private, GBU offers two-way encrypted email communication via our Secure Message Center.

Send An Encrypted Email

GBU Financial Life

A member-owned, not-for-profit provider of life insurance and annuity products since 1892.

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GBU products are currently available in the following states: AL, AK, AZ, AR, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NC, ND, OH, OK, PA, RI, SC, SD, TN, TX, UT, VT, VA, WV, WI, WY

Addresses

GBU Life

4254 Saw Mill Run Blvd.

Pittsburgh, PA 15227