Change my contact details


If you have recently changed your address or telephone number please fill out the form below to notify us of your new details, so we can update our records.

Please print out the form, complete the relevant sections, sign it and and send it back to us at the address listed at the bottom of the page.




Title:
Forename:
Surname:
Date of Birth:
   
Please enter your policy numbers:











   

Please enter your new postal address below:
Address 1:
Address 2:
Address 3:
City/Town:
County:
Country:
   
Email Address:
Your New Telephone Number:
Signature of policy holder:
Signature of joint policy owner (if applicable):
 
Date:
   

Please print and post your signed and completed form to:


Alterations Department
Canada Life
Canada Life House
Temple Road
Blackrock
Co.Dublin


We will not contact you to confirm your new details unless you request it. However if you do want us to contact you please tick the box below:
I would like you to contact me to confirm my new details