"Solid as the Rockies"
HOME
ABOUT WSA
PRODUCTS
FORMS
FRATERNAL
CONTACT
NEWS
More
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