Application for Cash Surrender Value or Policy Loan
You have accumulated cash value in your VA life insurance policy and want to borrow against it (loan), or you want to cancel the policy and receive the cash value (surrender).
Gather before you start
Section I - Policy Identification
Blocks 1-3Policy number, policy type, insured name and SSNPII
Your VA insurance policy number is on your policy document or annual statement from the VA Insurance Center.
(VA insurance policy number, policy type)
- Confusing different VA policies - have your annual statement on hand to identify the correct policy type and number.
Section II - Action Requested
Block 4Loan or full surrender?
LOAN: Borrow up to the policy cash value. You pay interest; the loan does not have to be repaid in a fixed schedule, but unpaid loan balance reduces the death benefit and can cause policy lapse. SURRENDER: Cancel the policy and receive all cash value. Policy ends permanently; you lose the death benefit and cannot reapply without medical underwriting.
e.g., Policy loan of $5,000. OR: Full cash surrender.
- Surrendering a VA policy when a loan would meet the immediate financial need - surrenders are permanent; loans allow the policy to continue.
- Not understanding that unpaid loan interest compounds and can cause the policy to lapse.
- Not knowing VALife and newer policies may not have loan provisions in the same way as older NSLI/VSLI policies.
Section III - Disbursement Information
Block 5Bank account for loan or surrender proceedsPII
VA disburses loan or surrender proceeds by ACH direct deposit. Provide bank name, routing number, and account number.
(bank routing and account numbers)
- Providing incorrect bank information - wrong routing number sends funds to wrong institution.
Section IV - Certification
Blocks 6-7Insured signature and datePII
Sign and date. Mail to VA Insurance Center, 5000 Wissahickon Avenue, Philadelphia PA 19144.
(signature/date)
- Mailing to the wrong address - VA Insurance is in Philadelphia, not a regional office.