Member Services & Forms
SNPJ is here to serve you, and as a way to help expedite your requests, we have made a list of forms available below. All of these forms can be downloaded and printed using Adobe Acrobat. Should you have any questions about your SNPJ life insurance or annuity certificate, please feel free to contact us.
Policy Information Change Forms
Change of Address Authorization Form
Change of Beneficiary Authorization Form
Change of Dividend Option Authorization Form
Change of Name Authorization Form
Change of Ownership Authorization Form
Declaration of Lost Policy/Annuity for Deceased Member
Exchange of Life Insurance/Annuity Policy
Request for Duplicate Policy
Medical & Disability Forms
Medical Report Form
Operation Claim Form
Childbirth Benefit Form
Disability for Loss of Eye or Eyesight Form
Disability for Loss of Limb(s)
Membership Applications (Agent Use)
SNPJ Membership Application
SNPJ Membership Application (Ohio)
SNPJ Membership Application (Illinois)
Miscellaneous Forms
Electronic Fund Transfer (EFT) Authorization Form
HIPAA Release Authorization Form
W-9 Form (opens irs.gov pdf in new window)
W-4P Form (opens irs.gov pdf in new window)
W-4R Form (opens irs.gov pdf in new window)
SNPJ Beneficiary Information Sheet
Lodge Community Service Form
Mailing address:
Slovene National Benefit Society
247 West Allegheny Road Imperial, PA 15126-9774
Phone Numbers:
(724) 695-1100
Toll-Free: 1-800-843-7675
Fax: (724) 695-1555
or (724) 695-1800
E-mail:
Office Hours:
Mon-Thurs: 8 a.m. to 5 p.m. EST
Fridays: 7:45 a.m. to 12:30 p.m. EST