PO Box 1344 Download the form below associated with your contract or policy and log in to upload the completed form. Create this form in 5 minutes! If you click a merchant link and buy a product or service on their website, we may be paid a fee by the merchant. The IRS instructions require reporting on IRS Form 1099-R in this manner. If you have registered for an online account, you may have the ability to request RMD payments online by logging into your secure account through our website. Get Form. Minneapolis, MN 55459-0060, Allianz Life Insurance Company of North America Agent/Rep Change of Address Form - M1217. This is required even after annuity payments have begun. Calpers Continued Monthly Residence Form - signNow What if I have questions about my claim or benefit payment options? If your Traditional or Roth IRA contract allows for additional premium, your contribution must be sent to a company-approved mailing address and postmarked by the due date for filing your return for that year, not including extensions. CLAIM FORM202 KB Also available in the following languages: ARABIC CLAIM FORM241 KB CHINESE CLAIM FORM619 KB LATVIAN CLAIM FORM238 KB RUSSIAN CLAIM FORM306 KB Regional Healthcare Plans Weve also adjusted our approved leave policies to ensure employees who are ill can take the time they need to recover, and have access to additional personal time as required to support the needs of their family and loved ones. Any traditional/personal IRA contributions you make directly to the SEP IRA will be reported in Box 1. Claim managemnet Liability Form. The first increase of 52% took effect beginning in November 2021. A new withdrawal form is required with each request. Many updates and improvements! A+ (Superior) and A (Excellent) are the 2nd and 3rd highest, respectively, of A.M. Best's 13 . Fixed annuities 763.582.6002 Get access to thousands of forms. Please consult a tax advisor on specifics regarding contributions for Traditional IRAs, Roth IRAs, SEP IRAs, and SIMPLE IRAs. If you are covered by one of our GlobalPass plans for Latin America, choose the relevant form below to claim back eligible medical expenses. We will be looking into this with the utmost urgency, The requested file was not found on our document library. As an issuer of the Individual Retirement Annuity (IRA), we are required to provide you and the IRS information on the contract annually. In addition, we are making sure financial professionals who work with Allianz Life have access to collaboration technologies to stay connected with clients. Policy Service and Claim Forms | My Bankers Life Mail Any determination that is to be made, such as to policy values, beneficiary, claim eligibility, or policy status, will take place. If you do not elect out of withholding, an amount equal to 10% withholding of the taxable amount for federal income tax (plus any mandatory state income tax if applicable) will be withheld. Can I surrender my Bajaj Allianz policy online? We do not currently accept payments through our website. Where does this amount show on my Form 5498? If Box 11 is checked on IRS Form 5498, then you are required to take an RMD from your contract. If you would like your contribution to be recorded for the 2022 tax year, please write 2022 contribution on your check. All you need is smooth internet connection and a device to work on. pdfFiller is not affiliated with any government organization. What are you doing to ensure the safety of your employees? Upon receipt of the required documents, we will process your claim within 10 business days or within the applicable state requirements. Include the date and place your electronic signature. After January 31, you can check to see if your statements are also available online by registering or logging in to your account and going to Current Statements." For tax-qualified annuities, your first annuity payment must be issued by December 31 in the year after the death to avoid potential tax penalties. By registering your account online, you will have access to contract values, statements, the ability to change allocations, and access to yearly tax statements. Claim Healthcare Form. All Overnight Mail Why did I get a 1099-R? explains the time frames associated with filing a new claim. Submit all forms and documents to: Mail: MetLife Long Term Care Claims PO Box 14407 Lexington, KY 40512-4633. PO Box 59060 . 5 hours ago Mail to: Nationwide Financial * Attn: Account Changes PO Box 182021 Columbus, Ohio 43218-2021 Fax to: 1-877-634-5264 Section. Surrender Value: The Policy can be surrendered provided three full years premiums have been paid. Allianz Care offers Emergency Healthcare Plans for groups who only wish to cover the medical emergencies of employees travelling abroad. Get the Senior Health Insurance Company Pennsylvania Continued Monthly Residence Form you want. Complete each fillable area. The group can be covered for single or multiple trips to the region where the healthcare plan is held for up to or a combined maximum of either: 90 travel days per insurance year each. account. You can also download it, export it or print it out. This means that although you will not have full access to the funds in a lump sum, you could have a taxable event. A 1035 exchange is reportable, but not taxable. Yes, the taxation of the death benefit proceeds for annuity payments is affected by the length of time between the date of death and the date the first payment goes out. Claim Healthcare Form. This checklist does not, If you choose to assign your long-term care insurance benefits to your covered provider, this form is required from your, Authorization to Release Medical Information, W-9 Request for Taxpayer Identification Number and Certification. PDF CLAIM FORM - Allianz Care Employer contributions to a SEP IRA will be reported in Box 8. We will contact the beneficiary for additional information if needed. If you are covered by one of the International Healthcare Plans for Qatar, use this form to claim back eligible medical expenses. Are there different kinds? Once logged in, go to My Policy," select Overview & Values," and scroll down to Required Minimum Distribution Values section. What measures does Allianz have in place to help protect me from fraud? Rating: 4.8/5 (52) After you contact us, the designated primary beneficiary will be mailed our claim form packet. 457 Transfer Request - PLI-039NY [NY] ABC Lifetime Withdrawal Election Form - . BULGARIAN CLAIM FORM363 KB POLISH CLAIM FORM457 KB For members of a group scheme Typically, these groups consist of 10 or more members. If Allianz did not receive transfer paperwork and a letter of acceptance from the other company, even if the check was made payable to the other company, we report the transaction because we do not have confirmation that the distribution went directly to an IRA at another company. laserapp.sales@ipipeline.com. Allianz does not accept starter checks. ", You can make beneficiary changes online. Just Now allianz continued monthly residence form. Cna continued monthly residence form Sunflower. If you are covered by our International Healthcare Plans for Mexico, use this form to claim back eligible medical expenses. Are these contributions stated on this form? RMD information is displayed on the Policy Detail screen under Accounts. Fixed annuities and Life insurance. LOGIN NOW In November 2020, the CalPERS board approved a rate increase on all Long-Term Care Program policies that was phased in over two years. Claim Form for underwritten groups. My contract is annuitized; why am I receiving this annual tax summary? If you are covered by one of the International Healthcare Plans for Vietnam, choose the relevant form below to claim back eligible medical expenses. If you have made any nondeductible contributions to an IRA, you should consult your tax professional to determine how much of the IRA distribution should be reported as taxable income. Making an investment and contending with different fund structures can be confusing. If your first non-tax qualified annuity payment is issued after one year from the date of death, the following will occur: We will report the entire taxable portion of the death benefit in the year in which the first payment is made. Decide on what kind of signature to create. 17 Station St., Ste 3 Brookline, MA 02445. We encourage you to contact your financial professional before making any final decisions regarding RMD. We are taking the utmost care for the health and safety of our employees and their families. Representative/Agent Change Complete form and mail to address located on the bottom of this form. Variable annuities variableannuity@send.allianzlife.com A transfer is not reported on a 5498 Form. Please check your spelling or try another term. Email variableannuity@send.allianzlife.com Allianz Global Investors is here to help. your physicians, medical practitioners, hospitals, clinics, etc. If you own an Allianz policy or contract and have registered your account online, you can log into your account here. If you make a contribution for 2022 between January 1, 2023 and the due date, your 2022 IRS Form 5498 will be updated to reflect the new contribution amount and will be mailed to you by May 31, 2023. You should receive a Form 1099-R from the distributing company. How do I change my beneficiary information? The 2022 IRS Form 5498 will reflect this change and will not show an RMD is required in 2023 for individuals whoare impacted. Policy not found You may continue without a policy number; however, you will need to print and mail or fax back the signed, completed form along with any required supporting documents to our home office. Life insurance 763.582.6002 Draw your signature, type it, upload its image, or use your mobile device as a signature pad. need to be returned. What should I do if I suspect fraud related to COVID-19? Surrender approved (Approved within 4 working days for standard cases) Surrender payout via e-Payment (Payout within 5 working days). , 10476 378 5 Tel . Please send your fully completed Claim Form(s) with any supporting invoices/receipts FRM-CF-EN-1019 (credit card slips cannot be accepted) by: Email to: claims@allianzworldwidecare.com Fax to: + 353 1 645 4033 Post to: Claims Department, Allianz Care, 15 Joyce Way, Park West Business Campus, Nangor Road, Dublin 12, Ireland What do I do if I forgot my account password? We have answers to the most popular questions from our customers. mozzart jackpot winners yesterday; new mandela effects 2021; how to delete a payee on barclays app Agent Instant Commissions - M1060. Im a beneficiary can I create an account online? Complete the quick two-step registration process to access your Allianz account online. Please send your fully completed Claim Form(s) with any supporting invoices/receipts (credit card slips cannot be accepted) as follows: Scan and email to: claims@allianzworldwidecare.com Fax to: + 353 1 645 4033 or Post to: Claims Department, Allianz Worldwide Care, 15 Joyce Way, Park West Business Campus, Nangor Road, Dublin 12, Ireland. The option is available to have your long-term care policy premiums deducted directly from your checking or savings Please note that online statements are not available for some clients. We do not currently allow beneficiaries to create an online account. The amount of income tax withheld will reduce the death benefit value dollar for dollar. The advanced tools of the editor will direct you through the editable PDF template. To protect customer data, some . For those born in 1951, their first RMD will not be due until they turn age 73. Preview 800.950.1962. Be cautious of investment opportunities tied to COVID-19, especially those based on claims that a small companys products or services can help stop the virus. However, any claim interest paid as part of the death benefit may be taxable. : Contract/Warranty Not applicable. Get Form. Please allow 5-7 business days to receive your statement(s) by mail. Where can I get more information about how my annuity product works in this environment? Life insurance 763.582.6002 The total distribution amount will be reported in Box 1 (gross distribution), the taxable portion of the distribution will be reported in Box 2a (taxable amount), and the amount of after-tax contribution (cost basis) will be reported in Box 5. If you are covered by one of the International Healthcare Plans for Singapore, choose the relevant form below to claim back eligible medical expenses. List of currently available ALLIANZ LIFE forms on Laser App, 222 Qualified Plan Acknowledgement Form and ERISA Disclosure - 222-ERPOS, 360 Qualified Plan Acknowledgement Form and ERISA Disclosure - 360-ERPOS, ABC Lifetime Withdrawal Election Form - S2301, ABC Qualified Plan Acknowledgement Form and ERISA Disclosure - ABC-ERPOS, Allianz 222 Annuity Disclosure - 222-DISC-NJ [NJ], Allianz 360 Annuity Disclosure - 360-DISC-NJ [NJ], Allianz ABC Annuity Disclosure - ABC-DISC-NJ [NJ], Allianz Core Income 7 Annuity Disclosure - CI7-DISC-NJ [NJ], Allianz Endurance Plus Annuity Disclosure - DISC50915-NJ03 [NJ], Allianz Index Advantage ADV Disclosure - IXA-DISC-ADV [PA], Allianz Index Advantage ADV Disclosure - IXA-DISC-MN-ADV [MN], Allianz Index Advantage Disclosure - INY-DISC [NY], Allianz Index Advantage Disclosure - IXA-DISC-MN [MN], Allianz Index Advantage Disclosure - IXA-DISC-PA [PA], Allianz Index Advantage Income Disclosure - IAI-DISC, Allianz Index Advantage Income Disclosure - IAI-DISC-MN [MN], Allianz Index Advantage Income Disclosure - IAI-DISC-PA [PA], Allianz Index Advantage NF Disclosure - IXA-DISC-MN-NF [MN], Allianz Index Advantage NF Disclosure - IXA-DISC-NF [MA-PA-VA], Allianz MasterDex X Annuity Disclosure - DISC52575-NJ01 [NJ], Allianz PRIME Plus Benefit Election Form for Reset of Annual Increase - USA-1282 [Generic], Allianz PRIME Plus Benefit Selection - USA-1279 [Generic], Allianz Request for Tax Withholding Change - SFAL0010, Allianz Request for Tax Withholding Change - SFAL0010-NY [NY], Allianz Retirement Advantage Lifetime Income Payment Selection Form - REA-014 [Generic], Allianz Retirement Advantage Lifetime Income Payment Selection Form - REA-014-NJ [NJ], Allianz Retirement Advantage NY Lifetime Income Payment Selection Form - REA-014-NY [NY], Allianz Retirement Advantage NY Variable Annuity Dollar Cost Averaging Instruction - REA-012-NY [NY], Allianz Retirement Advantage Variable Annuity Dollar Cost Averaging (DCA) Instructions - REA-012, Allianz Retirement Advantage Variable Annuity Flexible Rebalancing Instructions - REA-013, Allianz Retirement Advantage Variable Annuity Flexible Rebalancing Instructions - REA-013-NY [NY], Allianz Retirement Foundation ADV Annuity Application - ICC17-RFA-APP [Generic], Allianz Retirement Foundation ADV Annuity Application - RFA-APP [DC-DE-ND-SD], Allianz Retirement Foundation ADV Annuity Application - RFA-APP-CA [CA], Allianz Retirement Foundation ADV Annuity Application - RFA-APP-CT [CT], Allianz Retirement Foundation ADV Annuity Application - RFA-APP-FL [FL], Allianz Retirement Foundation ADV Annuity Application - RFA-APP-LA [LA], Allianz Retirement Foundation ADV Annuity Application - RFA-APP-NF, Allianz Retirement Pro - Income Advantage Payment Selection/Change Form - PLI-105-NY [NY], Allianz Retirement Pro NY Variable Annuity Withdrawal Request - PLI-110-NY [NY], Allianz RFA Annuity Disclosure - RFA-DISC-01-NJ [NJ], Allianz Vision - Add Income Protector to Existing Contract - USA-1453 [Generic], Allianz Vision - Income Focus Payment Selection/Change Form - PLI-123-NY [NY], Allianz Vision - Remove Form - USA-1419 [Generic], Allianz Vision - Remove Form - VNY-047 [NY], Allianz Vision and Allianz Collections - Income Focus Payment Selection/Change - USA-1729-NJ [NJ], Allianz Vision and Allianz Collections - Income Focus Payment Selection/Change Form - USA-1729, Allocation Change Form - Allianz Valuemark II - PLI-302-NY [NY], Allocation Change Form - Allianz Valuemark II - USA-1700 [Generic], Allocation Change Form - Alterity/ Rewards - USA-1649, Allocation Change Form - Custom Income - USA-1328 [Generic], Allocation Change Form - High Five NY/Advantage/Opportunity and Charter II NY - PLI-088 [NY], Allocation Change Form - High Five/High Five L/High Five Bonus - USA-1329 [Generic], Allocation Change Form - Retirement Pro - PLI-102-NY [NY], Allocation Change Form - Vision and Connections - Income Focus - USA-1728, Allocation Change Form - Vision and Connections - Income Protector (old) - USA-1451 [Generic], Allocation Change Form - Vision and Connections - Income Protector - USA-1727, Allocation Change Form - Vision and Connections - Investment Protector (old) - USA-1452 [Generic], Allocation Change Form - Vision and Connections - Investment Protector - USA-1780, Allocation Change Form - Vision and Connections - LPB and TDR - USA-1330 [Generic], Allocation Change Form - Vision and Connections - No Additional Benefit - USA-1781, Allocation Change Form - Vision NY - Income Focus - PLI-122-NY [NY], Allocation Change Form - Vision NY - Income Protector (old) - VNY-052 [NY], Allocation Change Form - Vision NY - Income Protector - VNY-162 [NY], Allocation Change Form - Vision NY - Investment Protector (old) - VNY-053 [NY], Allocation Change Form - Vision NY - Investment Protector - VNY-177 [NY], Allocation Change Form - Vision NY - LPB and TDR - PLI-089-NY [NY], Allocation Change Form - Vision NY - No Additional Benefit - VNY-178 [NY], Allocation Change Request Form - S2213-10, Allocation Change Request Form - S2213-12, Allocation Change Request Form - S2213-13, Allocation Change Request Form - S2213-14, Allocation Change Request Form - S2213-15, Allocation Change Request Form - S2213-16, Allocation Change Request Form - S2213-17, Allocation Change Request Form - S2213-18, Allocation Change Request Form - S2213-19, Allocation Change Request Form - S2213-20, Allocation Change Request Form - S2213-SR-20, Allocation Change Request Form - S2213-SR-9, Allocation Change Request Form - S2305 [IA], Allocation Change Request Form - S2306 [NH], Annuitant Change Request - SFAL0018-LA [LA], Annuitization Quote Request - PLI-119-NY [NY], Annuitizing Annuity and Life Contracts - PLI-115-NY [NY], Annuitizing Annuity and Life Contracts Packet - PLI-107-NY [NY], Annuitizing Annuity and Life Contracts Packet - USA-487 [Generic], Annuitizing Annuity Contracts and Life Insurance Policies - SFAL-0004, Annuitizing Annuity Contracts and Life Insurance Policies - SFAL-0004-NY [NY], Annuity Application - Bonus MasterDex - AP-50626-NY [NY], Annuity Application - ICC18-FIA-APP-ALT [IA], Annuity Application - ICC18-FIA-APP-MT [MT], Annuity Application - MasterDex - AP-50614-NY [NY], Authorization to Release Information - S2194, Authorization to Transfer Assets from a Financial Institution (Fixed) - S2255, Authorization to Transfer Assets from a Financial Institution (Fixed) - S2255-NY [NY], Authorization to Transfer Assets from a Financial Institution (Variable) - S2255, Authorization to Transfer Assets from a Financial Institution (Variable) - S2255-NY [NY], Automatic Investment Plan (AIP) Form - PLI-032-NY [NY], Automatic Investment Plan (AIP) Form - USA-1278 [Generic], Automatic Payment Plan - EFT Authrorization - NBAL0042, Automatic Payment Plan - EFT Authrorization - NBAL0042-NY [NY], Beneficial/Inherited IRA RMD Election Form - NBAL0036, Beneficial/Inherited IRA RMD Election Form - NBAL0036-NY, Beneficiary Designation Request - SFAL0012, Beneficiary Designation Request - SFAL0012-NY [NY], Beneficiary Stretch Distribution - PLI-098-NY [NY], Beneficiary Stretch Distribution - USA-1265N [Generic], Benefit Deposited with Interest Option Claim Form - S2070-01, Buyer's Guide for Fixed Deferred Annuities - ANB-LE (1999), Buyer's Guide for Fixed Deferred Annuities - ANB-LE (2013) [Generic], Buyers Guide for Deferred Annuities (Variable) - ANB-LA [GA], Buyers Guide for Deferred Annuities - ANB-LV (2013) [AL-CO-FL-GA-IA-ME-MO-NH-OH-RI-TX-WV-WI], Buyers Guide to Fixed Indexed Annuities - NB4023 [VT], California Elder Disclosure - NBAL0053 [CA], California Senior (age 60 or older) Free Look - USA-699 [CA], Certification for 72(t) and 72(q) Withdrawals - USA-388N, Certification for 72(t) and 72(q) Withdrawals - USA-388NY [NY], Certification of Attorney-in-Fact Form - NBAL0052, Certification of Attorney-in-Fact Form - NBAL0052-NY [NY], CI7 Qualified Plan Acknowledgement Form and ERISA Disclosure - CI7-ERPOS, Civil Union and Equality Act of 2011 Notice - NB6079 [DE], Client Contract Update Request - USA-383 [Generic], Client Contract Update Request - USA-383NY [NY], Command Provider Annuity Application - AIMS-CP [Generic], Command Provider Annuity Application - AIMS-CP-FL [FL], Command Provider Annuity Application - AIMS-CP-MA [MA], Command Provider Annuity Application - AIMS-CP-OR [OR], Command Provider Annuity Application - AIMS-CP-TX [TX], Commission Information Quick Guide - CIQG04, Connections Qualified Acknowledgement Form and ERISA Disclosure - CNT-ERPOS, Continuing Annuity Option Settlement Claim Form - S2069-01, Continuing Annuity Option Settlement Claim Form - S2069-NY [NY], Custom Income Flexible Rebalancing - USA-059 [Generic], Custom Income Variable Annuity Income Option Selection - CST-015 [Generic], Customer Authorization of Transfer by Third Party - USA-1300 [Generic], Customer Authorization of Transfer by Third Party - USA-1300-NY [NY], Customer Authorization of Transfer by Third Party Money Manager - USA-1301 [Generic], Customer Authorization of Transfer by Third Party Money Manager - USA-1301-NY [NY], Disclosure Form/Preliminary Contract Summary - 222-SOU-AZ [AZ], Disclosure Form/Preliminary Contract Summary - ABC-SOU-AZ [AZ], Disclosure Form/Preliminary Contract Summary - Allianz 360 - 360-SOU-AZ [AZ], Disclosure Form/Preliminary Contract Summary - Allianz Core Income 7 - CI7-SOU-AZ [AZ], Disclosure to California Residents (age 65 or older) - USA-090 [CA], Disclosure to Minnesota Resdients - Index Advantage ADV - IXA-DISC-MN2-ADV [MN], Disclosure to Minnesota Residents - Index Advantage ADV - IXA-DISC-MN2-NF [MN], Disclosure to Minnesota Residents - Index Advantage Income - IAI-DISC-MN2, Dollar Cost Averaging (DCA) - PLI-030NY [NY], Dollar Cost Averaging (DCA) - Retirement Pro - PLI-103-NY [NY], Dollar Cost Averaging (DCA) - USA-354 [Generic], Dollar Cost Averaging - Alterity/ Rewards - USA-1650, Enhanced Withdrawal Benefit (EWB) Election Form - S2291, Entity Customer Information Form - NBAL0055 [Generic], Entity Customer Information Form - NBAL0055-NY [NY], ERISA Section 408(b)(2) Disclosure - DISC52575-ERPOS, ERISA Section 408(b)(2) Disclosure - DISC54370-ERPOS, ERISA Section 408(b)(2) Disclosure - DISC59951-02-ERPOS, ERISA Section 408(b)(2) Disclosure - DISC95374-ERPOS, ERISA Section 408(B)(2)Disclosure - DISC95376-ERPOS, Five Year Deferral Service Form - S2241 [Generic], Five Year Deferral Service Form - S2241-NY [NY], Flexible Rebalancing - Alterity/ Rewards - USA-1651, Flexible Rebalancing - Retirement Pro - PLI-104-NY [NY], Income Maximizer Rider Disclosure Form - SOU95331-03-AZ [AZ], Income Maximizer Rider Statement of Understanding - SOU95331-03 [Generic], Income Maximizer Rider Statement of Understanding - SOU95331-03-CT [CT], Income Maximizer Rider Statement of Understanding - SOU95331-03-FL [FL], Income Maximizer Rider Statement of Understanding - SOU95331-03-OK01 [OK], Income Maximizer Rider Statement of Understanding - SOU95331-03-WI [WI], Income Maximizer Rider Statement of Understanding - SOU95331-GMV-03 [DE-IL-OH-TX], Income Maximizer Rider Statement of Understanding - SOU95331-GMV-03-NC [NC], Income Maximizer Rider Statement of Understanding - SOU95331-GMV-03-NJ [NJ], Income Maximizer Rider Statement of Understanding - SOU95331-ICC-04 [MN-MO-MS-UT], Income Maximizer Rider Statement of Understanding - SOU95331-ICC-04-OR [OR], Income Maximizer Rider Statement of Understanding - SOU95331-ICC-04-PA [PA], Income Maximizer Rider Statement of Understanding - SOU95331-ICC-NFWR-04 [AK-WA], Income Maximizer Rider Statement of Understanding - SOU95331-MSRP-03-CA [CA], Income Maximizer Rider Statement of Understanding - SOU95331-NFWR-03 [MA-SD], Income Payment Selection/Change Form - IAI-153 [Generic], Income Plus / Simple Income Benefit Election Form for Contract - S2212-1, InCommandDex Annuity Request for Annuity Settlement Options - S2160, Index Advantage ADV Qualified Plan Acknowledgement Form and ERISA Disclosure - IXA-ERPOS-ADV, Index Advantage ADV Variable Annuity Application Tipsheet - IXA-001-ADV, Index Advantage Income Qualified Acknowledgement Form and ERISA Disclosure - IAI-ERPOS, Index Advantage Income Variable Annuity Application - IAI-APP-03 [CA-DE-ND-SD], Index Advantage Income Variable Annuity Application - IAI-APP-03-FL [FL], Index Advantage Income Variable Annuity Application - IAI-APP-03-LA [LA], Index Advantage Income Variable Annuity Application - IAI-APP-03-NC [NC], Index Advantage Income Variable Annuity Application - ICC20-IAI-APP-03 [Generic], Index Advantage Income Variable Annuity Application - ICC20-IAI-APP-03-NJ [NJ], Index Advantage Income Variable Annuity Application - ICC21-IAI-APP-03-MN [MN], Index Advantage Income Variable Annuity Application Tipsheet - IAI-001, Index Advantage New York Qualified Plan Acknowledgement Form and ERISA Disclosure - INY-ERPOS [NY], Index Advantage New York Regulation 60 Forms Package - INY-055 [NY], Index Advantage NF Qualified Plan Acknowledgement Form and ERISA Disclosure - IXA-ERPOS-NF, Index Advantage NF Variable Annuity Application Tipsheet - IXA-001-NF, Index Advantage Qualified Plan Acknowledgement Form and ERISA Disclosure - IXA-ERPOS, Index Advantage Variable ADV Annuity Application - ICC20-IXA-APP-03-ADV [Generic], Index Advantage Variable ADV Annuity Application - ICC20-IXA-APP-03-NJ-ADV [NJ], Index Advantage Variable ADV Annuity Application - ICC21-IXA-APP-03-MN-ADV [MN], Index Advantage Variable ADV Annuity Application - IXA-APP-03-ADV [CA-DE-ND-SD], Index Advantage Variable ADV Annuity Application - IXA-APP-03-FL-ADV [FL], Index Advantage Variable ADV Annuity Application - IXA-APP-03-LA-ADV [LA], Index Advantage Variable ADV Annuity Application - IXA-APP-03-NC-ADV [NC], Index Advantage Variable ADV Annuity Application - IXA-APP-MOWA-01-ADV [MO-WA], Index Advantage Variable ADV Annuity Application - IXA-APP-MT-ADV [MT], Index Advantage Variable Annuity Application - F40538-02-NY [NY], Index Advantage Variable Annuity Application - ICC20-IXA-APP-03 [Generic], Index Advantage Variable Annuity Application - ICC20-IXA-APP-03 [HI], Index Advantage Variable Annuity Application - ICC20-IXA-APP-03-NJ [NJ], Index Advantage Variable Annuity Application - ICC21-IXA-APP-03-MN [MN], Index Advantage Variable Annuity Application - IXA-APP-03 [CA-DE-ND-SD], Index Advantage Variable Annuity Application - IXA-APP-03-FL [FL], Index Advantage Variable Annuity Application - IXA-APP-03-LA [LA], Index Advantage Variable Annuity Application - IXA-APP-03-NC [NC], Index Advantage Variable Annuity Application - IXA-APP-MOWA-01 [MO-WA], Index Advantage Variable Annuity Application Tipsheet - INY-016 [NY], Index Advantage Variable Annuity Application Tipsheet - IXA-001, Index Advantage Variable NF Annuity Application - ICC17-IXA-APP-NF [MT], Index Advantage Variable NF Annuity Application - ICC20-IXA-APP-03-NF [Generic], Index Advantage Variable NF Annuity Application - ICC20-IXA-APP-03-NJ-NF [NJ], Index Advantage Variable NF Annuity Application - ICC21-IXA-APP-03-MN-NF [MN], Index Advantage Variable NF Annuity Application - IXA-APP-03-FL-NF [FL], Index Advantage Variable NF Annuity Application - IXA-APP-03-LA-NF [LA], Index Advantage Variable NF Annuity Application - IXA-APP-03-NC-NF [NC], Index Advantage Variable NF Annuity Application - IXA-APP-03-NF [CA-DE-ND-SD], Index Advantage Variable NF Annuity Application - IXA-APP-MOWA-01-NF [MO-WA], Index Anniversary Rebalance Form - IAI-022 [Generic], Index Anniversary Rebalancing and Transfers between the Allocation Options - INY-019 [NY], Index Anniversary Rebalancing and Transfers between the Allocation Options - IXA-022, Individual Customer Information Form - NBAL0054 [Generic], Individual Customer Information Form - NBAL0054-NY [NY], Interested Party Statement Request - USA-851 [Generic], Interested Party Statement Request - USA-851-NY [NY], Investment Advisor Representative Client Authorization - NBAL0043, Investment Advisor Representative Client Authorization - NBAL0043-NY [NY], Investment Advisor Representative Information - NBAL0044, Investment Advisor Representative Information - NBAL0044-NY [NY], Investment Allocation Guide - VNY-142 [NY], Investment Allocation Guide - VSN-145 [Generic], IRA Excess Contribution Removal Form - S2235, IRA Excess Contribution Removal Form - USA-1506 [Generic], IRA Excess Contribution Removal Form - USA-1506-NY [NY], Lifetime Withdrawal Benefit/Income Maximizer Election Form - S2212-PREFD, Military Sales Forms Packet - USA-1461 [Generic], Military Sales Forms Packet - USA-1461 [NY], Non-Individual Ownership Form - NB6059-NY [NY], Non-Individual Ownership Form - PLI-086 [NY], Non-Individual Ownership Form - USA-1327 [Generic], Nonresident Sales Form - Information Page - NBAL6078, Nonresident Sales Form - Information Page - NBAL6078-NY [NY], Notice Regarding Medi-Cal Eligibility (Fixed) - NB5003-CA [CA], Notice Regarding Medi-Cal Eligibility (Variable) - NB5003-CA [CA], Notice to Connecticut Financial Professionals - IXA-DISC-CT2 [CT], Partial Settlement Options Request for Contract - S2247, Partial Settlement Options Request for Contract - S2247-NY [NY], Performance Lock Request Form - INY-106 [NY], Policy Payment Electronic Funds Transfer (EFT) - Clients - S2071, Policy Payment Electronic Funds Transfer (EFT) - Clients - S2071-NY [NY], PRIME - Guaranteed Partial Withdrawal Benefit (GPWB) Payment Election - 403(b) - PLI-100-NY [NY, PRIME - Guaranteed Partial Withdrawal Benefit (GPWB) Payment Election - 403(b) - USA-1567 [Generic], PRIME - Guaranteed Partial Withdrawal Benefit (GPWB) Payment Election - USA-1519 [Generic], PRIME Plus (GPWB) Payment Election - USA-1520, Producer Change Request - S2249 [Generic], Product Suitability Form - NB3051 [Generic], Product Suitability Form - NB3051-CA [CA], Product Suitability Form - NB3051-FL-02 [FL], Product Suitability Form - NB3051-MA [MA], Product Suitability Form - NB3051-MT [MT], Product Suitability Form - NB3051-NJ [NJ], Qualified Disbursement Request - S2085-NY [NY], Qualified Plan Acknowledgement - USA-337-NY [NY], Qualified Plan Acknowledgement and Custodial IRA Agreement - S2236, Qualified Plan Acknowledgement and Custodial IRA Agreement - S2236-NY [NY], Quick Tips for Completing the NY Reg 60 Disclosure Statement - PLI-120-NY [NY], Reg 60 Part D Tipsheet - Index Advantage NY - PLI-125-NY-IXA [NY], Reg 60 Part D Tipsheet - Retirement Pro NY - PLI-125-NY-RET [NY], Registered Representative Appointment Request - USA-678A [Generic], Registered Representative Appointment Request - USA-678NY [NY], Regulation 60 Disclosure Statement - NB2273-NY [NY], Regulation 60 Sales Material Checklist - NB2274-NY [NY], Regulation 60 Sales Material Checklist - PLI-081-NY [NY], Regulation 60 Six-Step Process - NB2278-NY [NY], Regulation 60 VA Disclosure Statement - PLI-092-NY [NY], Regulation 60 VA Replacement - PLI-090-NY [NY], Replacement Comparison Worksheet (Fixed) - NBAL0023-AR [AR], Replacement Comparison Worksheet (Variable) - NBAL0023-AR [AR], Replacement Comparison Worksheet - NB6023, Replacement Comparison Worksheet Tip Sheet (Fixed) - NBAL0022-AR [AR], Replacement Comparison Worksheet Tip Sheet (Variable) - NBAL0022-AR [AR], Replacement List (Fixed) - NBAL0028-IL [IL], Replacement Notice (Fixed) - NBAL0026-IL [IL], Replacement Notice (Fixed) - NBAL0037-KS [KS], Replacement Notice (Fixed) - NBAL0038-KS [KS], Replacement Of Life Insurance Or Annuities (Fixed) - NBAL0021-MO [MO], Replacement Of Life Insurance Or Annuities (Variable) - NBAL0021-MO [MO], Replacement Packet (Fixed) - NBAL0001-01 [LA-VA], Replacement Packet (Fixed) - NBAL0001-MO [MO], Replacement Packet (Fixed) - NBAL0002-CA [CA], Replacement Packet (Fixed) - NBAL0003-DE [DE], Replacement Packet (Fixed) - NBAL0004-FL [FL], Replacement Packet (Fixed) - NBAL0005-GA [GA], Replacement Packet (Fixed) - NBAL0006-ID [ID], Replacement Packet (Fixed) - NBAL0007-IL [IL], Replacement Packet (Fixed) - NBAL0008-IN [IN], Replacement Packet (Fixed) - NBAL0009-MA [MA], Replacement Packet (Fixed) - NBAL0010-MI [MI], Replacement Packet (Fixed) - NBAL0011-MN [MN], Replacement Packet (Fixed) - NBAL0013-ANN-NV [NV], Replacement Packet (Fixed) - NBAL0014-OK [OK], Replacement Packet (Fixed) - NBAL0015-PA [PA], Replacement Packet (Fixed) - NBAL0017-TN [TN], Replacement Packet (Fixed) - NBAL0018-WA [WA], Replacement Packet (Fixed) - NBAL0019-WY [WY], Replacement Packet (Fixed) - NBAL0020-AR [AR], Replacement Packet (Variable) - NBAL0001-01 [LA-VA], Replacement Packet (Variable) - NBAL0001-MO [MO], Replacement Packet (Variable) - NBAL0002-CA [CA], Replacement Packet (Variable) - NBAL0003-DE [DE], Replacement Packet (Variable) - NBAL0004-FL [FL], Replacement Packet (Variable) - NBAL0005-GA [GA], Replacement Packet (Variable) - NBAL0006-ID [ID], Replacement Packet (Variable) - NBAL0007-IL [IL], Replacement Packet (Variable) - NBAL0008-IN [IN], Replacement Packet (Variable) - NBAL0009-MA [MA], Replacement Packet (Variable) - NBAL0010-MI [MI], Replacement Packet (Variable) - NBAL0011-MN [MN], Replacement Packet (Variable) - NBAL0013-ANN-NV [NV], Replacement Packet (Variable) - NBAL0014-OK [OK], Replacement Packet (Variable) - NBAL0015-PA [PA], Replacement Packet (Variable) - NBAL0017-TN [TN], Replacement Packet (Variable) - NBAL0018-WA [WA], Replacement Packet (Variable) - NBAL0019-WY [WY], Replacement Packet (Variable) - NBAL0020-AR [AR], Replacement Packet - NAIC/multi-state (Fixed) - NBAL0001, Replacement Packet - NAIC/Multi-state (Variable) - NBAL0001, Representative/Agent Change Form - PLI-037NY [NY], Representative/Agent Change Form - USA-374 [Generic], Request for Allocation Change Form - S2068, Request for Allocation Change Form - S2266, Request for Allocation Change Form - S2266-1, Request for Allocation Change Form - S2266-2, Request for Allocation Change Form - S2267-1 [CA-HI-ID-OK-OR-RI], Request for Allocation Change Form - S2267-2, Request for Allocation Change Form - S2268, Request for Allocation Change Form - S2268-1, Request for Allocation Change Form - S2269, Request for Allocation Change Form - S2269-1, Request for Allocation Change Form - S2269-2, Request for Allocation Change Form - S2269-3, Request for Allocation Change Form - S2269-SR, Request for Allocation Change Form - S2269-SR-1, Request for Allocation Change Form - S2269-SR-2, Request for Allocation Percentage Chage (Optionsa) - MasterDex X - S2213-SR-5, Request for Allocation Percentage Change - BonusDe Elite, FlexDex MC Elite - S2075, Request for IRA Contribution Recharacterization - SFAL-0006, Request for IRA Contribution Recharacterization - SFAL-0006-NY, Request for IRA Recharacterization - S2187, Request for IRA Recharacterization - USA-1504 [Generic], Request for IRA Recharacterization - USA-1504-NY [NY], Request for Roth IRA Conversion - SFAL-0008 [Generic], Request for Tax Reporting of Premature Distribution Due to Disability - USA-1299 [Generic], Request for Tax Reporting of Premature Distribution Due to Disability - USA-1299-NY [NY], Request to Change Contract Information - S2004 [Generic], Request to Change Contract Information - S2004-NY [NY], Required Minimum Distribution (RMD) - Retirement Pro - PLI-112-NY [NY], Required Minimum Distribution (RMD) - USA-382N [Generic], Required Minimum Distribution (RMD) - USA-382NY [NY], Required Minimum Distribution Election Form - S2230 [Generic], Required Minimum Distribution Election Form - S2230-NY [NY], Retirement Pro - Certification for IRC Sec 72(t) or 72(q) Withdrawals - PLI-111-NY [NY], Retirement Pro VA 72(t) or 72(q) Withdrawals - USA-1598, Retirement Pro VA Allocation Change Form - USA-1574, Retirement Pro VA Dollar Cost Averaging (DCA) - USA-1575, Retirement Pro VA Flexible Rebalancing - USA-1576, Retirement Pro VA Income Advantage Payment Selection/Change Form - USA-1577, Retirement Pro VA Income Advantage Payment Selection/Change Form - USA-1577-NJ, Retirement Pro VA Required Minimum Distribution (RMD) - USA-1585, Retirement Pro VA Systematic Withdrawal - USA-1578, Retirement Pro VA Withdrawal Request - USA-1597, RFA Qualified Plan Acknowledgement Form and ERISA Disclosure - RFA-ERPOS, Rollover Notice - 403(b) - SFAL-0002-NY [NY], Rollover Notice Regarding Retirement Plan Payments - PLI-095-NY [NY], Sep IRA Excess Contribution Removal Form - USA-1507 [Generic], Sep IRA Excess Contribution Removal Form - USA-1507-NY [NY], SEP or SIMPLE Excess Contribution Removal Form - S2234, Settlement for Annuity Benefits - S2043-NY [NY], Simple Income II Rider Statement of Understanding - SOU91050-2 [DE-IA-MN-OH], Source of Payment (Fixed) - NBAL0041-NY [NY], Source of Payment (Variable) - NBAL0041-NY [NY], State Withholding Tax Guide - NBAL0035-NY [NY], Statement of Understanding - Death Benefit Rider - NB2222 [Generic], Statement of Understanding - Death Benefit Rider - NB2222-AZ [AZ], Statement of Understanding - Death Benefit Rider - NB2222-MT [MT], Statement of Understanding - Death Benefit Rider - NB2222-OK [OK], Statement of Understanding - Flexible Withdrawal Rider - SOU95178-1 [Generic], Statement of Understanding - Flexible Withdrawal Rider - SOU95178-1-PA [PA], Statement of Understanding/Preliminary Contr.
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