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Home > Member
Service Center |
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USBA Member Forms |
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 Some of our most commonly requested forms are now available online such as Change of Beneficiary, Name/Address Change, Account Permission, Pay Method, Scholarship.
Just click
on the link to the form you need, submit online (if available), OR print, fill in the requested information,
and mail the completed form to us:
USBA
P.O. Box 25956
Overland Park, KS 66225-0956
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Request for Change of Beneficiary
If you want to change your beneficiary arrangement, download the form here.
Beneficiary Change Form – Sign-in to the Member Service Center to use this form.
Request for Change of Name
If you’ve changed your name and need us to update our records, fill out this online form or download the Print & Mail version and send to us:
USBA Name Change Form – Sign-in to the Member Service Center to use this secure form.
Print and Mail-in USBA Name Change Form
Request for Change of Address
If you want to notify USBA of an address change, fill out this online form or download the Print & Mail version and send to us:
USBA Address Change Form – Sign-in to the Member Service Center to use this secure form.
Print and Mail-in USBA Address Change Form
(Or go back to the Member Contact form and notify us by e-mail.
Be sure to include your current address and phone, your new address, and the effective date you’ll be at the new address.)
Permission to Receive Account Information
Click here if you want to give your spouse or someone else permission to get information
about your USBA coverage. (NOTE: We are not allowed to disclose this information unless we
have signed permission from the owner of the coverage.)
Member Pay Forms
Automatic Payment Options
For your convenience, USBA monthly payments can be made through military
allotment or USBA EZ PAY. To start or change an automatic pay method,
click on the appropriate link below.
USBA EZ PAY (Automatic Bank Draft)
Using this convenient pay method, your insurance premium is automatically
deducted from your bank account each month. Simply deduct your insurance
premium amount from your bank balance on the first of every month. USBA does
the rest.
Online EZ PAY form – you must sign into the Member Service Center to use this secure form.
Print and Mail-in EZ PAY Form
Bank Change Form – Use only if you are currently paying your USBA premiums by EZ PAY (formerly known as Checkmatic) and need to make a bank change.
Military Allotment
Premium payment by allotment is available to those drawing Active Duty or
Retired military pay (except retired PHS). It offers the convenience of having
your insurance premium deducted from your pay and sent directly to USBA. The
allotment will be sent to USBA each month—no hassle of writing a check, plus
your premium is always paid on time.
Just call us at (800) 821-7912 if you have questions or need assistance
in completing the allotment form.
Start a New Allotment Deduction
To start a NEW allotment, select your duty status and branch of service. Then
print the form. Once completed, file it with your Finance Center or Finance
Officer. Filing instructions are provided on each form.
Active Duty Army
Active Duty Air Force or Navy
Active Duty Coast Guard
Active Duty Marine Corps
Active Duty NOAA
Retired Air Force, Army, Marine Corps, or Navy
Retired Coast Guard
Change an Existing Allotment Deduction
To CHANGE an existing USBA allotment, select your branch of service and duty
status. Then print the form. Be sure to complete all information needed. Your
current USBA allotment amount can be found on your LES statement. Filing
instructions are provided on each form.
Active Duty Air Force or Navy
Active Duty Army
Active Duty Coast Guard
Active Duty Marine Corps
Active Duty NOAA
Retired Air Force, Army, Marine Corps, or Navy
Retired Coast Guard
Request for Dietrich Scholarship Application
Click here for information about USBA’s William A. Dietrich Memorial
Scholarship. It’s offered to graduating high school seniors each school
year. Applications must be received at USBA by March 31 prior to graduation. |
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