Equitable Reserve Association

Fraternal Forms

• Change of Chapter (PDF)
• Disaster Relief (PDF)
• Traditional Scholarship (PDF)
• Non-Traditional Scholarship (PDF)
• Volunteer Record Form (PDF)

Policy Forms

• Automatic Payment Withdrawal (APW) (PDF)
• Change of Address (PDF)
• Change of Name and Beneficiary (PDF)

Rider Application Forms

These forms are to be used when applying for Living Need Accelerated Benefits Rider, and the forms are state-specific. Please choose the appropriate form based on your state.

• All States EXCEPT Indiana (PDF)
• State of Indiana (PDF)

Thank You For Being a Friend!

We want to thank you for helping us grow!  If someone you refer to Equitable Reserve Association purchases a LifeStyle 5000 policy or an annuity, we will reward you with a check (1 per household that you refer).

This check will be worth $50-$75 depending on policy/annuity purchased.

To hear more about this opportunity, call your agent or Equitable Reserve’s Marketing Services at 1-800-722-1574.  We want to thank you for helping us grow!

All forms are provided in PDF format and will require the Adobe Acrobat Reader.