Customer Care Forms
IMPORTANT: Click on the state name for certificates in the state of CALIFORNIA or OREGON.
Other states please use the forms below:
All Customer Care Forms May be Sent in by Mail ONLY. Mail originals, no copies please.
MAIL: 1891 Financial Life, 200 N. Martingale Rd. Ste. 405, Schaumburg, IL 60173
- Change of Beneficiary
- Change of Legal Name
- Change of Address / Update
- Change of Ownership
- Required Minimum Distribution (RMD)
- Reduced Paid Up Election
- Annuity Contribution
- Direct Deposit Authorization
Make a Payment
The form for payment by credit card, debit card, or Electronic Funds Transfer (EFT) may be sent in by:
MAIL: 1891 Financial Life, 200 N. Martingale Rd. Ste. 405, Schaumburg, IL 60173
FAX: 847-342-4556
EMAIL: info@1891FinancialLife.com
- Form: Payments by Credit Card, Debit Card, or Electronic Funds Transfer (EFT)
- Online: Pay Your Bill Online or Set Up Recurring Payments
Claims
All Claims Forms May be Sent in by Mail ONLY. Mail originals, no copies please.
MAIL: 1891 Financial Life, 200 N. Martingale Rd. Ste. 405, Schaumburg, IL 60173
- Life / Annuity Claim Form
- Direct Deposit Authorization
- Beneficiary Assignment of Proceeds
- Federal Withholding Election Non Qualified Annuity
- Federal Withholding Election IRA (Individual Retirement Annuity)
- Affidavit of Acknowledgement and Agreement for Death Benefit Payment
- Choose one:
Outreach Forms
1891 Financial Life firmly believes we can all be heroes. Participate in volunteer opportunities we champion to support our members and communities. Below are forms for individual benefits like grants and scholarships or forms for Impact Team fundraising.
All Membership and Impact Team Forms may be sent in by:
MAIL: 1891 Financial Life, 200 N. Martingale Rd. Ste. 405, Schaumburg, IL 60173
FAX: 847-342-4556
EMAIL: outreach@1891financiallife.com
Learn about your benefits:
Outreach forms for individual Members
Media Release – If you are taking pictures or videos at an event, please have members and guests grant permission – through a signed Media Release form – to use the photographs and/or videos in Society publications.
Membership’s Scholarship
- Application DUE March 1
- College Scholarship Application
- Master’s Scholarship Application
- May Apply 1 x Per Year
- Occupational Scholarship Application
Hope Scholarship
- Application DUE August 31
- Hope Scholarship Application – Dolores “Dolly” Roberts
- Send a donation to the Hope Scholarship Fund: CLICK HERE
Member of the Year forms DUE May 15
- Junior Member of the Year: Nomination Form for ages up to 16 years
- Young Adult Member of the Year: Nomination Form for ages 17 to 25 years
- Member of the Year: Nomination Form or ages 26 and over
Membership’s Grant Applications DUE May 31
- Catholic Preschool Grants
- Catholic Grade School Grants
- Catholic High School Grants
- Religious Education Program Grants (CCD)
- Continuing Education Grants
Ambassador Application – 1891 Ambassador is a passionate member of our Society that would like to take their enthusiasm to the next level. Ambassadors help spread the word about 1891 and the good works that Impact Teams do in their communities.
- Ambassador Application
Pop-Up Impact Team Event – An individual beneficial member (age 16+) may gather their friends and family together to create an event 2x/year.
Recommender Award – A member, social member or non-member may receive a $25 stipend for each non beneficial member they refer to the home office who becomes a beneficial member.
Social Membership Application – Social membership is available for those not purchasing a product but are still looking to be a part of the 1891 community.
Transfer of Membership
Forms for Impact Teams
Start an Impact Team – Fill out this application to start a new impact team.
Impact Team Grant Application DUE 60 days before date funds needed – Each impact team may apply for $125 of additional funding. Grants not guaranteed. Each application will be reviewed by the Outreach and Engagement Department. Limit 1 grant annually per court.
Impact Team Project Forms
- Hearts and Hands Application
- Hearts and Hands Summary
- Join Hands Day Summary Form
- Alzheimer’s Support: National Project Summary Form
Religious Life Education Matching Funds DUE 3 weeks before meeting – 1891 offers the Religious Life Education Fund (or ReLiEF). 1891 will match funds raised by impact teams in the diocese. These funds are presented at a Diocesan Association Meeting.
Impact Team Audit Forms DUE February 15 – The audit is the responsibility of the president and treasurer. The books and accounts of the impact team must be audited every 12 months. Return your forms with one year of bank statements.
Impact Team Activity Forms DUE February 15 – The activity form is the responsibility of the president and secretary. Record the type of event and how many were held, volunteer hours for that event and how much money was spent (disbursement).
Impact Team Officer Elections DUE February 15 – An impact team holds its elections in January. The forms are completed with current elected officer information and returned to the Home Office.
All Membership and Impact Team Forms May be Sent in by:
MAIL: 1891 Financial Life, 200 N. Martingale Rd. Ste. 405, Schaumburg, IL 60173
FAX: 847-342-4556
EMAIL: outreach@1891FinancialLife.com
Customer Care Forms may be Sent in by:*
MAIL: 1891 Financial Life, 200 N. Martingale Rd. Ste. 405, Schaumburg, IL 60173
FAX: 847-342-4556
EMAIL: info@1891FinancialLife.com
*May may be required to be sent in by Mail only, contact a representative at 855-804-7424
Completed Life Insurance and Annuity Applications May be Sent in by:
MAIL: 1891 Financial Life, 200 N. Martingale Rd. Ste. 405, Schaumburg, IL 60173
FAX: 847-342-4556
EMAIL: sales@1891FinancialLife.com