Minneapolis, MN 55440-0561. Get your online template and fill it in using progressive features. In times like these, financial matters may be the last thing on your mind. You can begin the claims process online or by contacting us by phone. View More. What changes can I make to my account online? Can I surrender my Bajaj Allianz policy online? allianz continued monthly residence form allianz claim Create this form in 5 minutes! If they are negotiable, or you make an offer you can change? If you are covered by one of the International Healthcare Plans for Qatar, use this form to claim back eligible medical expenses. Jackson recognizes that information security is critical to maintaining the trust of our customers and advisors. Once you have registered your account online, you can log into select your eDelivery preferences. How is Allianz helping those impacted by COVID-19? Forms that have been reused will not be honored. SEP IRA contributions Allianz receives in 2023 will be reported on the 2023 Form 5498, even when the employer deducts the SEP contribution on their 2022 tax return. Allianz Life Insurance Company of North America (Allianz), its affiliated companies, and their representatives and employees do not provide legal or tax advice. Thats why weve designed our claims process in three steps so you can focus on what matters most. This form is provided for your convenience in the event your home health care provider does not have their own daily If the distribution did go directly to an IRA at another company, please provide us with confirmation of this from the receiving company. One can fi nd out the surrender value of the policy on the online portal of the insurance company. Use a check mark to point the choice wherever expected, See Also: Allianz ltc claim forms Show details, 2 hours ago If you are covered by one of our GlobalPass plans for Latin America, choose the relevant form below to claim back eligible medical expenses. Where can I find my policy or contract statement? Why is there a taxable amount on a loan from a 403(b) annuity contract? 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. A beneficiary is the person or entity that is entitled to the death benefit of the annuity contract or life insurance policy. You should consult a tax professional for information on the proper income tax reporting of a rollover from an IRA. The beneficiary will receive a claim form packet from Allianz. If youre not sure when premium is due or how much you need to pay, contact us or confirm with your financial professional. How to create an eSignature for the allianz care form. By completing and, This form is provided for your convenience in the event your home health care provider does not have their own daily, This form is designed to help you stay organized while submitting a new home health care claim. Why is the total distribution amount reported in Box 1 (gross distribution)? Upon receipt, the Allianz Claims department will evaluate your claim within 10 business days. Email variableannuity@send.allianzlife.com Changing Your Beneficiary or Monthly Benefit After Retirement 16 Removing. If you own an Allianz policy or contract, you can register for online access. Minneapolis, MN 55459-0060, Allianz Life Insurance Company of North America Upon receipt, the Allianz Claims department will evaluate your claim within 10 business days. We do not currently allow beneficiaries to create an online account. Senior Health Insurance Company Pennsylvania Continued Monthly My contract is annuitized and Im receiving annuity payments; what is my required distribution amount? By completing and What portion of my death benefit is taxable? The packet includes contract-specific information that must be completed and returned to us. Get the Senior Health Insurance Company Pennsylvania Continued Monthly Residence Form you want. allianz continued monthly residence form - tissue-queens.com 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. 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. 17 Station St., Ste 3 Brookline, MA 02445. After the taxable amount is reported to you as income, you will not be taxed on this amount again when annuity payments begin; instead only earnings from the annuity payments will be taxable each year. 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. Please consult a tax professional for any questions related to this reporting. Please be aware there may be different death benefit values available to a beneficiary depending upon the claim option that is elected. Here are steps you can take to help protect yourself: Know when payments are due. Typically, the Fair Market Value (FMV) in Box 5 is the only information provided. The RMD Election Form is provided below under the section titled Forms.. How to create an eSignature for the allianz care form. Allianz Global Assistance can be signNowed toll free within North America at 1-844-310-1578. How do I know if Required Minimum Distributions (RMDs) have been set up on my contract? If you have more than one Allianz contract, please verify that you have specified the correct contract number. calpers long term form one-size-fits-all solution to design calpers continued monthly residence form? If the annuity contract is anon-tax-qualifiedannuity, any amount over the owner's cost basis (generally the after-tax contributions that were made by the owner) in the contract is taxable as ordinary income. This form isfor your records onlyand does not need to be attached to your submitted income tax return. Claim Professional realestate Form. ABC Qualified Plan Acknowledgement Form and ERISA Disclosure - ABC-ERPOS. allianz continued monthly residence form allianzlife com forms allianz agent change allianz 1099 Related to allianz life insurance forms . Requests to take the required minimum distribution from a fixed annuity can be made online. If this form is not submitted with your claim form it may delay our handling of your claim. Use professional pre-built templates to fill in and sign documents online faster. PO Box 1344 Fax 763.582.6004 RMD information is displayed on the Policy Detail screen under Accounts. Minneapolis, MN 55459-0060, Variable and index variable annuities Use direct deposit to receive secure electronic payments. If I want to elect annuitization payments to receive the death benefit, are there any time periods I need to be concerned with? A confirmation letter will also be mailed under separate cover that includes payment and taxability details. Cna Application G 142826 a Form - SignNow 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. Your claim form packet will contain a cover letter that includes death benefit values. 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. 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. allianz continued monthly residence form 360 Qualified Plan Acknowledgement Form and ERISA Disclosure - 360-ERPOS. Allianz Global Investors is here to help. The Direction to Pay form is provided as a convenience to our policyholders and their care providers If you would, The option is available to have your long-term care policy premiums deducted directly from your checking or savings, To submit a request for an eligibility determination, a claim form and additional information is required to initiate this, The claim information package contains the documents to explain the claim filing process and the forms you may need, If you choose to assign your long-term care insurance benefits to a covered provider, you must submit the Direction to, It may be necessary for us to request additional information to reach an eligibility determination. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. Edit your allianz life beneficiary change form online. Producer Services 763.582.6005. Calpers Continued Monthly Residence Form - signNow Any determination that is to be made, such as to policy values, beneficiary, claim eligibility, or policy status, will take place. 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. If you have an RMD due in 2023, an RMD Election Form can be completed and submitted to us by mail or fax. Life insurance 763.582.6002 Investor Education. The mailing address and fax number are provided on the form for your convenience. Success. Where does this amount show on my Form 5498? 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. I thought only my gains were taxable on a distribution from a nonqualified annuity. 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. 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. About Fixed Index Universal Life Insurance, Allianz Life Insurance Company of North America, Date of birth and/or Social Security number (SSN) of deceased. The beneficiary will receive a claim form packet from Allianz. As the issuer of the individual retirement annuity (IRA), we are required to provide you and the IRS information on your contract annually. Just Now For Taiwan Investors only Allianz Global Investo rs Taiwan Limited, 5F, No. Refer to the step below that aligns closest to your current situation. The beneficiary will receive a claim form packet from Allianz. 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. Insurance fraud can be broadly defined as an intentional act or omission undertaken to gain unjustified or unlawful benefits and advantages. How do I access my policy or contract online? If Box 11 is checked on IRS Form 5498, then you are required to take an RMD from your contract. You can also download it, export it or print it out. 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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