General Forms

Form

Use this form to...

Notes

Application for Change of Address

Request change of address for certificates and/or payer

Must be signed by the insured and payer/owner

Automated Clearing House (ACH) Authorization

Authorize electronic funds transfer to pay your life premiums, annuity deposits, or mortgage payment to WSA

Include a voided blank check or deposit slip showing your pre-printed routing transit number and bank codes

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