Get this form now! 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). Its a good idea to contact your financial professional or issuing agent to review and determine the best options for your situation. Upload Tax forms will be sent to the beneficiary in the year following payment if applicable. Open them in the editor, fill out, e-sign, and share them right from your browser. Calpers Long Term Care Program Continued Monthly Residence Form Where do I find my Form 1099-R statement? 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). 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. Where can I find my policy or contract statement? No. Why did I get a 1099-R? Minneapolis, MN 55416-1297, Fax June 1, 2020. . Log inand then go to "Archived Statements. Fax I hereby authorize the Allianz Funds to provide copies of my monthly account statements to the individuals set forth below. PDF Long-Term Care Guide to Service Provider Payment - Facility - MetLife The IRS requires the use of specific distribution codes for different types of distributions which need to be reported separately. See your Form 1099-R instructions regarding Box 7 for IRS distribution code information. to assign benefits to the care provider, but not the rights under the policy. Surrender value is the amount of premium refunded to the policyholder after a few years of premium payment. Fixed annuities 763.582.6002 For example, they might use cdc.com or cdc.org instead of cdc.gov.. laserapp.sales@ipipeline.com. If you are covered by one of the International Healthcare Plans for Qatar, use this form to claim back eligible medical expenses. Allianz Global Assistance and Allianz Travel Insurance are brands of AGA Service Company. For non-tax-qualified annuities, your first annuity payment must be made within one year from the date of death. My contract is annuitized and Im receiving annuity payments; what is my required distribution amount? Investor Education. For Bajaj Allianz life insurance login to our portal policybachat.com. The beneficiary will receive a claim form packet from Allianz. Please note: If a claim isn't filed within a certain number of years after the death, it is considered unclaimed property and is sent to the state in accordance with state requirements. Get access to thousands of forms. Please reference the contract number on each page of all forms and any accompanying correspondence. Share your form with others Send allianz form s2043 via email, link, or fax. Use direct deposit to receive secure electronic payments. Get Bankers Life Proof Of Residence Form - US Legal Forms Schedule secure automatic premium payments. 4 hours ago Insurance benefits underwritten by BCS Insurance Company or Jefferson Insurance Company, depending on insureds state of residence and plan type. Once logged in, go to My Policy," select Overview & Values," and scroll down to Required Minimum Distribution Values section. The amount of income tax withheld will reduce the death benefit value dollar for dollar. To submit a request for an eligibility determination, a claim form and additional information is required to initiate this View More. PDF Claim Form - Allianz Care PO Box 1344 The first increase of 52% took effect beginning in November 2021. your physicians, medical practitioners, hospitals, clinics, etc. ", You can make beneficiary changes online. We follow a variety of procedures to verify that any annuity contract or life insurance policy you buy from us meets your stated needs. Allianz Care Form 2018-2023 - SignNow What do I do if I forgot my account password? Allianz does not issue any tax reporting on custodial IRAs or qualified plans such as pension plans, Keoghs, 401(k) plans, or defined benefit plans. What if I have questions about my claim or benefit payment options? It is to be completed by a licensed health care practitioner. This form is required to verify the needs of the claimant. Policy Service and Claim Forms | My Bankers Life For Licensing. Life insurance 763.582.6002 If you are covered by one of the International Healthcare Plans for Indonesia, choose the relevant form below to claim back eligible medical expenses. June 29, 2022. If any portion of this distribution is not redeposited within 60 days, this portion will be considered taxable and no longer qualifies as a rollover contribution. Be wary of unsolicited emails offering information, supplies, or treatment for COVID-19 or requesting your personal information for medical purposes. Personal contributions are reported on the form for the year for which the contributions were made. If you must use the United States Postal Service (USPS) to pay premium, allow significant additional time and protect yourself by using the priority mail service or by securing a Certificate of Mailing. 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. 4. Please allow 5-7 business days to receive your statement(s) by mail. 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. My employer made contributions to a SEP IRA. Get access to thousands of forms. Life insurance: 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. Log inand go to "Personal Accounts.. ", Address changes can be made online. Mail Keywords relevant to allianz life insuranc company of north america continued monthly residence form. The beneficiary will receive a claim form packet from Allianz. We are remaining fully operational to support all customers and their financial professionals with normal access to our products, services, and support channels. Upon receipt, the Allianz Claims department will evaluate your claim within 10 business days. 457 Transfer Request - PLI-039NY [NY] ABC Lifetime Withdrawal Election Form - . Requests to take the required minimum distribution from a fixed annuity can be made online. Please note that online statements are not available for some clients. Surrender approved (Approved within 4 working days for standard cases) Surrender payout via e-Payment (Payout within 5 working days). Section 1 Taxpayer s rst name M. I. Log in or registerand go to " Personal Accounts. 01. RMD information is displayed on the Policy Detail screen under Accounts. LTCG Portal ", Beneficiary changes can be made online. We will contact the beneficiary if additional information is needed. SECTION 3: How to submit this form . Mail Email variableannuity@send.allianzlife.com We do not currently allow beneficiaries to create an online account. Continued Monthly Residence (CMR) Form 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. A death claim requires the beneficiary to complete and return the claim form packet with one copy of the certified death certificate. PDF Forms | Shipltc We strongly encourage all customers to consult their financial professionals about their unique personal needs and situation. Enter your Birthday Last 4 SSN Enter the last 4 digits of your Social Security Number. If 2022 contribution is not on your check, we will apply the money as a 2023 contribution. BULGARIAN CLAIM FORM363 KB POLISH CLAIM FORM457 KB For members of a group scheme Typically, these groups consist of 10 or more members. Past statements on active Allianz policies and contracts are available online. To do so, register or log in to your account, click on your name in the upper-right corner, and select Delivery Preferences from the drop-down menu. Variable annuities 763.765.7912 Forms that have been reused will not be honored. View More. All you need is smooth internet connection and a device to work on. Claim Healthcare Form. Email Refer to the step below that aligns closest to your current situation. Forms | Jackson office. ABC Qualified Plan Acknowledgement Form and ERISA Disclosure - ABC-ERPOS. Allianz forms: Fill out & sign online | DocHub Jackson recognizes that information security is critical to maintaining the trust of our customers and advisors. You should receive a Form 1099-R from the distributing company. Long Term Care Insurance Forms | Genworth ", Mail Decide on what kind of signature to create. The packet includes contract-specific information that must be completed and returned to us. 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. 2019 Daily-catalog.com. We also monitor your product for suspicious requests or transactions, and confirm any changes to your account in writing. Many updates and improvements! Get Form. Make a phone payment. Please read the "To File a Claim" instructions included in the Claim Information Package. If you can't find an answer to your question, please contact us. account. 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? Why is there a taxable amount on a loan from a nonqualified annuity? 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. If you had a taxable distribution in more than one resident state, a separate 1099-R would generate for each state. 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. How do I know if Im scheduled for an RMD distribution? return completed form to: claims department/2700 west plano parkway/plano, tx 75075 800.251.7254/ FAX: 866.586.6528 - - Male Female Enter your official contact and identification details. Contact us for assistance. This site uses cookies to enhance site navigation and personalize your experience. The mailing address and fax number are provided on the form for your convenience. 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. By using this site you agree to our use of cookies as described in our, allianz authorization to transfer funds form, allianz withdrawal request form for annuity contract. See Also: Customer Service Templates Show details. allianz form s2043 allianz form s2043 allianz s2043 download allianz form s2071 allianz company form Allianz Life Insurance Company of North America PO Box 59060 Minneapolis, , See Also: Allianz long term care formsVerify It Show details, 6 hours ago Related to allianz life insuranc company of north america continued monthly residence form allianz company form Allianz Life Insurance Company of North America PO Box 59060 Minneapolis, MN 554590060 Phone: 800.950.1962 Fax: , See Also: Ship continued monthly residence formVerify It Show details. We encourage you to consult your tax and/or legal advisor with any related questions. The advanced tools of the editor will direct you through the editable PDF template. This document outlines the forms that are necessary to file a new claim under your SHIP long-term care policy and When logged into your account, you can make changes to your contract allocations and beneficiary. Click the Start a claim button to start the claims process. By completing and The surrender value is paid to the policyholder at the time of surrender. Create this form in 5 minutes! This form is designed to help you stay organized while submitting a new home health care claim. allianz reimbursement form. See Also: Cna continued monthly residence form Show details, 7 hours ago 20202022 Form Allianz Life S2043 Fill Online, Printable . Success. Independently verify the identity of any company, charity, or individual that contacts you regarding COVID-19. Please refer to the account number box on the 1099-R. We have answers to the most popular questions from our customers. This box is also generally checked for a distribution from an IRA (Traditional, SEP, SIMPLE or Roth). How can I avoid potential policy issues related to mail delivery delays? How to fill out and sign bankers life casuality company continued monthly residence form online? This means that although you will not have full access to the funds in a lump sum, you could have a taxable event. You will also need to complete Section 5 tax withholding information if you wish to elect out of federal tax withholding. Long-term disability LTD benefits replace 66 23 of your base monthly. ", First log in, then click on the policy or contract number(s) displayed under "My Account. How to create an eSignature for the allianz care form. Allianz Life Insurance Company of North America Research any charities or crowdfunding sites soliciting donations in connection with COVID-19 before giving any donation. Changing Your Beneficiary or Monthly Benefit After Retirement 16 Removing. After you contact us, the designated primary beneficiary will be mailed our claim form packet. A transfer is not reported on a 5498 Form. See your Form 1099-R instructions regarding Box 7 for IRS distribution code information. when filing a new claim. We will mail Forms 1099-R and 5498 by January 31, 2023. Note: As part of SECURE 2.0 Act of 2022, signed into law on December 29, 2022, the RMD age is changing for people who were born in 1951 or later. To request your RMD withdrawal, please download and complete the form associated with your contract or policy andlog into upload the completed form. PO Box 561 Get Form How to create an eSignature for the continental casualty company continued monthly residence form Please follow the instructions on the form if you would like your policy premiums deducted automatically. . Any employer contributions will show as SEP IRA contributions. Why is the taxable amount not determined Box 2b checked? 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 - 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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 - 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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.