SecurChoice™ Trust Forms & Applications

SecurChoice™ Trust forms for pre-need funeral funding are available in PDF format for download.

Once downloaded to your computer, the electronic PDF files allow you to type in information in the blank fields to complete the form. The forms can also be printed out and filled in by hand. An actual signature is still required on the completed forms.

Pre-Need and Individual Trust Agreement – Parts I, II, III
(form must be mailed with payment to SecurChoice)
DOWNLOAD FORM

Additional Payment To Existing Trust
(form must be mailed with payment to SecurChoice)
DOWNLOAD FORM

Standard Withdrawal Certificate
(form & death certificate may be faxed or mailed to SecurChoice)
DOWNLOAD FORM

In order to fill out and print the downloaded PDF file, you will need to have the Adobe Acrobat Reader software installed on your computer.

You can download the latest version of Adobe Acrobat Reader free, by clicking on the link below.
DOWNLOAD ACROBAT READER


Mailing Information:
SecurChoice™
7441 Allentown Boulevard
Harrisburg, PA 17112

Fax: 717-545-7360

Questions?
If you have questions, or need assistance in completing the forms, please contact Ruth Carrera ruth@pfda.org or Teri Morgan teri@pfda.org via email or by calling 800-692-6068.