How is Allianz helping those impacted by COVID-19? Enter your official contact and identification details. What is Allianz Life doing to support customers and policyholders? If they are negotiable, or you make an offer you can change? Money that was sent directly from one IRA into another IRA is considered a transfer. Use direct deposit to receive secure electronic payments. If you had a taxable distribution in more than one resident state in a calendar year, a separate 1099-R would generate for each state. Please reference the contract number on each page of all forms and any accompanying correspondence. What is the due date (last date) that I can make a contribution for tax year 2022 to my Traditional IRA and/or Roth IRA? Please consult a tax advisor on specifics regarding contributions for Traditional IRAs, Roth IRAs, SEP IRAs, and SIMPLE IRAs. For non-tax-qualified annuities, your first annuity payment must be made within one year from the date of death. How can I verify that my financial professional is properly qualified and licensed? 360 Qualified Plan Acknowledgement Form and ERISA Disclosure - 360-ERPOS. Why is the taxable amount not determined Box 2b checked? In times like these, financial matters may be the last thing on your mind. Claim Form for underwritten groups. Your claim form packet will contain a cover letter that includes death benefit values. This form is provided for your convenience in the event your home health care provider does not have their own daily This checklist does not The CMR form must be completed for facility claims by an authorized representative of the facility on a monthly basis and submitted with the bill(s) after the end of each month. 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. 17 Station St., Ste 3 Brookline, MA 02445. If you own an Allianz policy or contract and have registered your account online, you can log into your account here. need to be returned. Allianz Global Assistance and Allianz Travel Insurance are brands of AGA Service Company. allianz continued monthly residence form. SECTION 3: How to submit this form . Producer Services 763.582.6005, To change your account allocation, log inand go to " Personal Accounts. A newly completed form is required for all requests. If you would like your contribution to be recorded for the 2022 tax year, please write 2022 contribution on your check. 50 of the value of the food - Oaks Amusement Park, Gift Forms And Functions Exchang - ShopAmericaNG, CAMP CLARK WILLIAMSON FACILITY & GROUNDS USE POLICY. When you call, well ask you to provide the contract number or Social Security number (SSN) of the deceased. Collateral assignments or taxable ownership changes on nonqualified annuities. Fixed Annuities & Life Insurance A 1035 exchange is reportable, but not taxable. Why is there a taxable amount on a loan from a 403(b) annuity contract? Representative/Agent Change Complete form and mail to address located on the bottom of this form. June 1, 2020. . Yes, if a claim isn't filed within a certain number of years it is considered unclaimed property and would be sent to the state in accordance with applicable state requirements. 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. What changes can I make to my account online? Many prospective customers may find it hard to trust an annuity firm, but the industry has put in place guidelines to evaluate these companies. Complete the quick two-step registration process to access your Allianz account online. allianz claim. Log inand go to "Personal Accounts.". If you are covered by our International Healthcare Plans for Lebanon, use this form to claim back eligible medical expenses that occurred outside of Lebanon. You can also update your address, email, username, password, or mobile phone number. If you are covered by our International Healthcare Plans for Kuwait, use this form to claim back eligible medical expenses. This form is required to recognize and work with deponents as the sole, legal, equitable, and unrestricted heirs to the What is the amount that I am allowed to contribute to my Traditional IRA and/or Roth IRA for year 2022? Claim Healthcare Form. Transfer Ownership and/or Change Beneficiaries. Thats why weve designed our claims process in three steps so you can focus on what matters most. Log in and go to Personal Accounts. We will contact the beneficiary if additional information is needed. Yes, if a claim isn't filed within a certain number of years it is considered unclaimed property and would be sent to the state in accordance with applicable state requirements. need to be returned. For most individuals, contributions for 2022 must be postmarked no later than April 18, 2023. Get the Senior Health Insurance Company Pennsylvania Continued Monthly Residence Form you want. I sent money from another IRA directly into this IRA at Allianz. Log inand go to "Personal Accounts. Feb 28, 2022. Requests for a withdrawal from a fixed annuity can be made online. My contract is annuitized; why am I receiving this annual tax summary? No additional withdrawals are necessary. Mail Make a phone payment. Life insurance lifeinsurance@send.allianzlife.com, Mail Types of beneficiaries may include an individual, minor, trust, estate, or a qualified retirement plan. Please check your spelling or try another term. Please be aware there may be different death benefit values available to a beneficiary depending upon the claim option that is elected. 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. 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. . Allianz receives document and process surrender. Are there time limitations for filing a death claim? Follow the simple instructions below: The times of distressing complex tax and legal documents have ended. 457 Transfer Request - PLI-039NY [NY] ABC Lifetime Withdrawal Election Form - . Please note that online statements are not available for some clients. Fax: 866-722-1180. Allianz reports any amount that it receives via this method in Box 2 (Rollover Contributions) on Form 5498. Representative must be appointed with Allianz Life Insurance Company of North America. Here you can find all the legal documents, forms and literature on our funds. Upload Email fixedannuity@send.allianzlife.com To get started, the following information will be helpful in submitting your claim: Frequently asked questions for returning claim form packet: What is a beneficiary? The guaranteed minimum surrender value in case of surrender before the due date of first survival benefit is 30 % of all premiums paid excluding the first year premium and the premiums for all additional benefits. Requests to take the required minimum distribution from a fixed annuity can be made online. Once your contract is annuitized, each annuity payment is considered your Required Minimum Distribution (RMD). Typically, a policy with three years of successful premiums paid acquires a surrender value. For Licensing. Life insurance 763.582.6002 We will mail Form 5498 by January 31, 2023. Allianz Life Insurance Company of North America Also available in the following languages: Typically, these groups consist of 10 or more members. If you believe that this page should be taken down, please follow our DMCA take down process here. The display of third-party trademarks and trade names on this site does not necessarily indicate any affiliation or endorsement of daily-catalog.com. 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. Allianz Life Insurance Company of North America If the Scheduled RMD indicates No," then RMD payments have not been set up on the contract being viewed. Allianz Life Insurance Company of North America 03. when filing a new claim. Edit your form settlement option online Type text, add images, blackout confidential details, add comments, highlights and more. Enter your Birthday Last 4 SSN Enter the last 4 digits of your Social Security Number. The RMD Election Form is provided below under the section titled Forms.. LOGIN NOW This form is required to recognize and work with deponents as the sole, legal, equitable, and unrestricted heirs to the, Due to HIPAA regulations, we are unable to release your personal information without your authorization. PO Box 59060 For non-tax-qualified annuities, your first annuity payment must be made within one year from the date of death. Making an investment and contending with different fund structures can be confusing. Our Claims Informationpage will help you learn about the process and what information you will need to provide. Tax forms will be sent to the beneficiary in the year following payment if applicable. All you need is smooth internet connection and a device to work on. Malicious actors and threats increase during times of crisis, particularly in the current environment. pdfFiller is not affiliated with any government organization. If you are covered by our International Healthcare Plans for Mexico, use this form to claim back eligible medical expenses. Variable annuities 763.765.7912 For some contracts, withdrawals taken may be subject to an MVA adjustment. Please note that online statements are not available for some clients. How do I change my beneficiary information? Please see information in the above question for details on how to terminate a payment. When you make a payment, write down confirmation numbers, print receipts, and/or take screen shots. We are taking the utmost care for the health and safety of our employees and their families. After you contact us, the designated primary beneficiary will be mailed our claim form packet. Annuities: Genworth's long term care insurance forms will assist you with conducting authorizations, changing your name/address, naming a beneficiary, changing your long term care coverage and conducting other updates to your policy/certificate. More. PO Box 561 The IRS requires the use of specific distribution codes for different types of distributions which need to be reported separately. Claim Form for individual members. O. 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. 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). We also monitor your product for suspicious requests or transactions, and confirm any changes to your account in writing. Complete each fillable area. Upon receipt of the completed claim form packet and certified death certificate, the Allianz Claims department will evaluate your claim within 10 business days (or within applicable state requirements). Any traditional/personal IRA contributions you make directly to the SEP IRA will be reported in Box 1. Note: Additional documents may be required if you are a minor beneficiary, trust beneficiary, estate beneficiary, foreign beneficiary, or a qualified retirement plan beneficiary. allianz continued monthly residence form allianz forms download allianz s2067 form allianz authorization to transfer funds form allianz withdrawal request form for annuity contract allianz death claim form allianz claim form pdf allianz life forms allianzlife.com login Learn more Learn more Learn more Learn more be ready to get more This document outlines the forms that are necessary to file a new claim under your SHIP long-term care policy and 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 choose to assign your long-term care insurance benefits to a covered provider, you must submit the Direction to Allianz Global Investors is here to help. Monday Thursday Know your salesperson before you buy any financial product. Use this step-by-step guide to fill out the Form allianz swiftly and with ideal accuracy. PO Box 561 We will contact the beneficiary for additional information if needed. If you are covered by our International Healthcare Plans for the UAE, use this form to claim back eligible medical expenses. These transactions typically include, but are not limited to: For a nonqualified annuity, Allianz did not receive the after-tax contribution (cost basis) information from the previous company. Where does this amount show on my Form 5498? We encourage you to talk with a financial professional about the role an annuity can play in your overall financial plan. Apt. Minneapolis, MN 55416-1297, Fax Just Now For Taiwan Investors only Allianz Global Investo rs Taiwan Limited, 5F, No. This form isfor your records onlyand does not need to be attached to your submitted income tax return. If I want to elect annuitization payments to receive the death benefit, are there any time periods I need to be concerned with? You will also be able to download additional service forms pertaining to your contract or policy. Standard and Poors (SP), Moodys and A.M. Best are three such authorities, and each member of the trio has rated Allianz within the top 25% of their rankings. By registering your account online, you will have access to contract values, statements, the ability to change allocations, and access to yearly tax statements. Allianz 222 Annuity Disclosure - 222-DISC-NJ [NJ] If you received distributions from multiple contracts, you will get a 1099-R for each contract. Cna continued monthly residence form Sunflower. In addition, we are making sure financial professionals who work with Allianz Life have access to collaboration technologies to stay connected with clients. Agent/Rep Change of Address Form - M1217. This form is required to verify the needs of the claimant. There are some steps you can take to help prevent this from happening to you: To help protect you from fraud, Allianz provides periodic statements of your products activity. If you perform an eligible 60-day rollover (indirect rollover), the IRS Form 5498 from the receiving company should report the receipt of the indirect rollover contribution. The packet includes contract-specific information that must be completed and returned to us. PO Box 1344 Change the blanks with smart fillable areas. Otherwise, you can report suspected fraud by calling the National Center for Disaster Fraud (NCDF) hotline (1-866-720-5721) or by e-mailing the NCDF at disaster@leo.gov. Box Area Code / Phone Unlisted Mailing Address If different from above i.e. Log inand go to "Personal Accounts.. Edit your allianz life beneficiary change form online. 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. Get Form How to create an eSignature for the continental casualty company continued monthly residence form If you are covered by one of the International Healthcare Plans for Qatar, use this form to claim back eligible medical expenses. 1 hours ago The IRS requires the use of specific distribution codes for different types of payments, which need to be reported separately. Producer Services 763.582.6005. Allianz Global Assistance can be signNowed toll free within North America at 1-844-310-1578. If you click a merchant link and buy a product or service on their website, we may be paid a fee by the merchant. Once you have registered your account online, you can log into select your eDelivery preferences. If you will receive the first payment outside of these timeframes, contact us to discuss your specific situation. Our highest priority is the health and well-being of our customers, partners, and employees during these extraordinary times. Variable annuities 763.765.7912 This is required even after annuity payments have begun. Why did I get a 1099-R? Due to HIPAA regulations, we are unable to release your personal information without your authorization. return completed form to: claims department/2700 west plano parkway/plano, tx 75075 800.251.7254/ FAX: 866.586.6528 - - Male Female 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. Schedule secure automatic premium payments. How do I access my policy or contract online? This email with intrauterine growth, and who renders the dtf oversees the web at calpers continued care program pays the. How to create an eSignature for the allianz care form. Minneapolis, MN 55459-0060, Allianz Life Insurance Company of North America We encourage you to contact your financial professional before making any final decisions regarding RMD. Im a beneficiary can I create an account online? This means that although you will not have full access to the funds in a lump sum, you could have a taxable event. Log in and go to Personal Accounts. I did a 1035 exchange of my nonqualified annuity or life insurance policy. You can also ask your tax professional if an RMD is required from your contract. 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. (typically, consisting of 3 to 9 members) Claim Form for non-underwritten groups. Producer services 763.582.6005. Forms that have been reused will not be honored. In addition, we continue to identify and provide new tools and technologies to help us stay connected with each other and our customers. We follow a variety of procedures to verify that any annuity contract or life insurance policy you buy from us meets your stated needs. Upon receipt of the completed claim form packet and proof of death (i.e., death certificate) from the beneficiary, we will evaluate the claim within 10 business days or within applicable state requirements. A 1099-R is used to report transactions that occur between January 1 and December 31 of the previous tax year from financial products such as life insurance or annuities. Are there time limitations for filing a death claim? Calpers Continued Monthly Residence Form. After January 31, you can check to see if your statement is also available online by registering or logging in to your account and going to "Current Statements." Refer to the step below that aligns closest to your current situation. You can begin the claims process online or by contacting us by phone. Download the form below associated with your contract or policy andlog into upload the completed form. Whereas underwritten groups typically consist of 3 to 9 members. An IRA-to-IRA indirect rollover occurs when money is received by you from one IRA and redeposited into another IRA within 60-days of receipt of the funds. Long-term disability LTD benefits replace 66 23 of your base monthly. 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 - 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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 - 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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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