home  |  about  |  careers  |  contact  |  site map  | 
MassMutual
executive benefits: forms

We have several downloadable forms for your convenience. Printed and completed documents can either be mailed to the address shown on the form or faxed to (860) 562-6154, unless Medallion Signature Guarantee is required or otherwise noted in the description below. All files are in Adobe Acrobat format.

Form Name Description PDF
Beneficiary Change Form Change the beneficiary of your policy.
Change of Owner and Beneficiary Change the owner or beneficiary of your policy.
Certificate of Foreign Status (W-8) Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding.
Certification of Trust Agreement Required if ownership changes to a trust.
Certification of Trust Agreement (NY) Required if ownership changes to a trust. (NY)
Service Request Form Use this form for: Changes to Automatic Premium Loan; Face Amount Decrease; Name Change; Change of Address; Death Benefit Option Change.
Split Dollar Form (SL4-13) SL4 -13 split dollar agreement.
Request for Policy Loan Request a loan on your policy.
Taxpayer Identification (W-9) This will certify your Social Security number with MassMutual.
Strategic Edge Group Flexible Premium Adjustable Life Insurance (GVUL) Specific Service Forms
GVUL Pre-Authorized Direct Payment Service Request Form Pre-Authorized direct payment service from your bank account.
GVUL Fund Transfer Request Form This form should be used to transfer Account Value between Separate Account Divisions and the Guaranteed Principal Account (GPA).
GVUL Future Net Premium Allocation Change Form This form should be used to change your allocation of future net premiums among Separate Account Divisions and the Guaranteed Principal Account (GPA).
Strategic GUL/GVUL Premium Election Form Premium election form to make additional contributions to your GVUL policy.
GVUL Partial Withdrawal Form To request a partial withdraw from your GVUL policy.
Large Case Variable Life Plus (SL6) Specific Service Forms
SL6 Fund Transfer Request Form This form should be used to transfer Account Value between Separate Account Divisions and the Guaranteed Principal Account (GPA).
SL6 Future Net Premium Allocation Change Form This form should be used to change your allocation of future net premiums among Separate Account Divisions and the Guaranteed Principal Account (GPA).
SL6 Partial Withdrawal To request a partial withdraw from your SL6 policy.
Strategic Variable Life (SL9) Specific Service Forms
SL9 Fund Transfer Request Form This form should be used to transfer Account Value between Separate Account Divisions and the Guaranteed Principal Account (GPA).
SL9 Future Net Premium Allocation Change Form This form should be used to change your allocation of future net premiums among Separate Account Divisions and the Guaranteed Principal Account (GPA).
SL9 Partial Withdrawal To request a partial withdraw from your SL9 policy.
Strategic Variable Life Plus (SL10) Specific Service Forms
SL10 Fund Transfer Request Form This form should be used to transfer Account Value between Separate Account Divisions and the Guaranteed Principal Account (GPA).
SL10 Future Net Premium Allocation Change Form This form should be used to change your allocation of future net premiums among Separate Account Divisions and the Guaranteed Principal Account (GPA).
SL10 Partial Withdrawal To request a partial withdraw from your SL10 policy.
Back to Top
If you can't find the form you are looking for, or you need more information about the use of any of these forms, please contact your agent or call our Customer Service Center. Executive Group Life Customer Service can be reached at (800) 548-0073, and Corporate and Bank Owned Life Insurance Customer Service can be reached at (800) 665-2654. The Customer Service Center is open Monday through Friday, 8 a.m. – 5 p.m. Eastern Time.
help / service
Need help, fast? MassMutual has a range of online service and support options ready to help you.
service
forms
performance
Check out current performance information for the MassMutual Financial Group companies' Annuity, IRA, Executive Benefits and Variable Life products.
go
contact a financial professional
Experienced financial professionals from MassMutual Financial Group companies can help you develop the right financial strategy to meet your needs.
contact
how a financial professional can help you
locate an office
Please enter a ZIP code or a city and state to locate a sales office near you.
ZIP Code
City or Town
State
required plug-in
Adobe Acrobat Reader Adobe Acrobat Reader
999999
privacy / legal notice