Forms
Please mail completed forms to:
FCSU Home Office
6611 Rockside Rd
Suite 300
Independence, OH 44131
fcsu@fcsu.com
fax: 216-642-4310
Address Change Form
To change your address or to update your contact information please fill out the update profile form.
Annuity Forms and Applications
Annuity Forms
- Affidavit of Lost Policy
- Annuity Suitability Questionnaire
- One Time Annuity Cash Withdrawal
- Multiple Withdrawal Annuity Cash Withdrawal
- Assignment of Annuity Contract
- Cash Interest Option Enrollment and Cancellation Form
- Direct Deposit Enrollment Form
- IRA Transfer Form
- 1035 Exchange Form
- Preauthorized Charge Form
- Replacement Notice
- 5305-Simple
- 5305-SEP
- Qualified Charitable Distribution
- Federal Tax Withholding Form
Annuity Applications
Please select the state in which you reside.
Select StateIf your state is not listed please fill out this application.
Park 2 Applications
Please select the state in which you reside.
Select StateIf your state is not listed please fill out this application.
Coverdell Education Savings Account Applications
Please select the state in which you reside.
Select StateIf your state is not listed please fill out this application.
Insurance Forms and Applications
Insurance Forms
Insurance Applications
Please select the state in which you reside.
Select StateInsurance Applications (JEP Only)
Please select the state in which you reside.
Select StateMiscellaneous Forms
FCSU Forms
Beneficiary/Ownership Change Form
Branch Forms
- Branch Announcement Form
- Deposit Agreement Withdrawal Form
- Branch Annual Report
- Branch Attendance Sheet
- Branch Directory 2024
- Branch Financial Statement
- Member Transfer Form
Cash Withdrawal of your Insurance Policy
Death Claim Forms
- Affidavit for Lost Policy of a Deceased Member
- Death Claim Report
- Instructions for Filing a Life Insurance Death Claim
- Direct Deposit Enrollment Form
District Forms
- District Allowance Form
- District Attendance Sheet
- District Directory Form
- District Financial Statement