PRSA application forms

Application forms

PRSA application form
PRSA AVC application form

Note: for cases below €1,800 p.a., please contact your account manager.

PRSA top up form
PRSA employer designation form
PRSA payroll deduction authority
Direct Debit mandate
PEP RCA supplementary form

Irish Life Financial Services ltd. is regulated by the Central Bank of Ireland. Irish Life Assurance plc. is regulated by the Central Bank of Ireland.
Irish Life Financial Services ltd and Irish Life Assurance plc Registered Office - Lower Abbey Street, PO Box 129, Freepost, Dublin 1. Phone: 01 704 2000.
Irish Life Financial Services Registered Number 489221. Irish Life Assurance plc Registered Number 152576.
In the interest of customer service, we will record and monitor calls.