SNPJ Member Services & Forms

SNPJ is here to serve you, and as a way to help expedite your requests we have made available a list of forms below, any of which 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)

Miscellaneous Forms

Electronic Fund Transfer (EFT) Authorization Form
W-9 Form (opens pdf in new window)
W-4P Form (opens 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


Office Hours:

Mon-Thurs: 8 a.m. to 5 p.m. EST
Fridays: 7:45 a.m. to 12:30 p.m. EST