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 log into the Member Portal and submit the form.
Annuity Forms and Applications
*Please print and sign the completed form before submitting to FCSU.
Annuity Forms
- 1035 Exchange Form
- 5305-EA
- 5305-SEP
- 5305-Simple
- Affidavit of Lost Policy
- Annuity and IRA Automatic Withdrawal Form
- Annuity and IRA Withdrawal Form
- Assignment of Contract
- Beneficiary Update Form
- Cash Interest Option Form
- Direct Deposit Enrollment Form
- Federal Tax Withholding Form
- IRA Transfer Form
- Preauthorized Credit Charge Form
- Qualified Charitable Distribution
- Replacement Notice
- Successor Owner Addendum
- Successor Owner Addendum (FL)
- Successor Owner Addendum (SC)
- Successor Owner Addendum (TX)
Annuity / IRA Applications
If your state is not listed please fill out this application.
Park 2 Applications
If your state is not listed please fill out this application.
Coverdell Education Savings Account Applications
If your state is not listed please fill out this application.
Insurance Forms and Applications
*Please print and sign the completed form before submitting to FCSU.
Insurance Applications
Insurance Applications - Short
Short Applications:
JEP: Ages 0-21; Amounts up to $25,000
Whole Life: $5,000 -$10,000
FCSU Scholarship winners: $3,000 paid up application
Claims Forms
*Please print and sign the completed form before submitting to FCSU.
Branch and District Forms
*Please print and sign the completed form before submitting to FCSU.
Miscellaneous Forms
*Please print and sign the completed form before submitting to FCSU.