If you will receive the first payment outside of these timeframes, contact us to discuss your specific situation. You will also need to complete Section 5 tax withholding information if you wish to elect out of federal tax withholding. Are these contributions stated on this form? Just Now allianz continued monthly residence form. explains the time frames associated with filing a new claim. Depending on the option selected, payment will be , 1 hours ago Allianz Real Estate, one of the worlds largest real estate investment managers, has seen its global logistics portfolio grow to EUR 11.6 billion in assets under management as at the end of 2021, up 32% year-on-year. allianz continued monthly residence form allianz claim Create this form in 5 minutes! You should receive a Form 1099-R from the distributing company. Minneapolis, MN 55459-0060 My contract is annuitized and Im receiving annuity payments; what is my required distribution amount? The death benefit amount that you receive from the contract or policy may also vary based on your death benefit payment option that you elect. Any traditional/personal IRA contributions you make directly to the SEP IRA will be reported in Box 1. Please consult a tax professional for any questions related to this reporting. The advanced tools of the editor will direct you through the editable PDF template. How to fill out and sign bankers life casuality company continued monthly residence form online? Transfer Ownership and/or Change Beneficiaries. . If youre not sure when premium is due or how much you need to pay, contact us or confirm with your financial professional. It may be necessary for us to request additional information to reach an eligibility determination. Allianz does not accept starter checks. Surrender Value: The Policy can be surrendered provided three full years premiums have been paid. (typically, consisting of 3 to 9 members) Claim Form for non-underwritten groups. Agent Eligibility Quick Guide - AEQG04. Allianz 222 Annuity Disclosure - 222-DISC-NJ [NJ] For non-tax-qualified annuities, your first annuity payment must be made within one year from the date of death. Please see information in the above question for details on how to terminate a payment. 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. Personal contributions are reported on the form for the year for which the contributions were made. For individual members and underwritten groups, International Healthcare Plans for Singapore, CLAIM FORM FOR UNDERWRITTEN INDIVIDUAL MEMBERS AND GROUPS, International Healthcare Plans for Indonesia, International Healthcare Plans for Vietnam, International Health Insurance for Corporates, Small Business International Health Insurance, International Health Insurance for Diplomats, International Critical Illness Cover for Business, Short Term Health Insurance for Business Travel. Claim Professional lawyers-profitability Form. Log inand go to "Personal Accounts. Share your form with others Send allianz form s2043 via email, link, or fax. They can offer important benefits to help you accumulate for retirement, provide a level of protection for your savings, and offer guaranteed income for life. Or, download the form below associated with your contract or policy andlog into upload the completed form. laserapp.sales@ipipeline.com. For non-tax-qualified annuities, your first annuity payment must be made within one year from the date of death. Email to assign benefits to the care provider, but not the rights under the policy. 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. Save time and skip the bank line by signing up for direct deposit for one-time and recurring withdrawals. How do I know if Required Minimum Distributions (RMDs) have been set up on my contract? Allianz Life Insurance Company of North America Use professional pre-built templates to fill in and sign documents online faster. Our highest priority is the health and well-being of our customers, partners, and employees during these extraordinary times. Edit your allianz life beneficiary change form online. What do I do if I forgot my account password? The mailing address and fax number are provided on the form for your convenience. Requests for a withdrawal from a fixed annuity can be made online. We will mail Forms 1099-R and 5498 by January 31, 2023. How do I request to stop it? need to be returned. 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. Get Form How to create an eSignature for the continental casualty company continued monthly residence form Fax 763.582.6004 Log in or registerand go to " Personal Accounts. This form is designed to help you stay organized while submitting a new nursing facility claim. How can I verify that my financial professional is properly qualified and licensed? allianz continued monthly residence form. How can I find my policy or contract value? Fixed annuities and Life insurance. P. O. Allianz Life Insurance Company of North America There are three variants; a typed, drawn or uploaded signature. Collateral assignments or taxable ownership changes on nonqualified annuities. process. If Box 11 is checked on IRS Form 5498, then you are required to take an RMD from your contract. By using this site you agree to our use of cookies as described in our, Something went wrong! Reminder: If you complete an IRA-to-IRA indirect rollover, you generally cannot, within a 12-month period from the date you received the distribution, make another indirect rollover of a distribution from any of your IRAs to another IRA. We will mail Form 1099-R by January 31, 2023. Your cost basis has been increased to the extent of any gain reported on Form 1099-R as taxable, so you will not be taxed on this amount twice. I thought only my gains were taxable on a distribution from a nonqualified annuity. 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. Pay form to SHIP. Are there time limitations for filing a death claim? See Also: Customer Service Templates Show details. Life insurance 763.582.6002 Upon receipt, the Allianz Claims department will evaluate your claim within 10 business days. If the annuity contract is atax-qualified annuity, such as an IRA, the entire amount of the death benefit will generally be fully taxable. Download the form below associated with your contract or policy andlog into upload the completed form. Accountholder Details , See Also: Free CatalogsVerify It Show details, 8 hours ago Allianz Life Insurance Company of North America 5701 Golden Hills Drive Minneapolis, MN 55416-1297 Mailing Transfer Form/Check to Allianz Allianz Fixed Annuity and Life Addresses: Residence address (street required) City State ZIP code Email address, 2 hours ago Continue without a policy # by selecting the company and policy type. Allianz Care offers Emergency Healthcare Plans for groups who only wish to cover the medical emergencies of employees travelling abroad. Minneapolis, MN 55416-1297 (typically, consisting of 10+ members), See Also: Allianz claim form pdf Show details, 8 hours ago CalPERS Long-Term Care Program CONTINUED MONTHLY RESIDENCE FORM Instructions: The Continued Monthly Residence (CMR) form is a required part of the monthly claim submission and must be completed thoroughly by facility staff. If you are covered by our International Healthcare Plans for Mexico, use this form to claim back eligible medical expenses. Enter your Birthday Last 4 SSN Enter the last 4 digits of your Social Security Number. You may also be able to request a withdrawal or schedule a required minimum distribution (RMD) payment stream. The option is available to have your long-term care policy premiums deducted directly from your checking or savings The second increase of 25% took effect beginning in November 2022. Follow the step-by-step instructions below to design your continued monthly residence form: Select the document you want to sign and click Upload. I sent money from another IRA directly into this IRA at Allianz. Please complete our Forgot password formand we will email a temporary password to the email address associated with your account. Box Area Code / Phone Unlisted Mailing Address If different from above i.e. 01. View More. For most individuals, contributions for 2022 must be postmarked no later than April 18, 2023. For some contracts, withdrawals taken may be subject to an MVA adjustment. How does Allianz ensure that my best interests are protected when purchasing an annuity or life insurance? Allianz reports any amount that it receives via this method in Box 2 (Rollover Contributions) on Form 5498. 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. Claim Healthcare Form. Log inand then go to "Archived Statements. If you can't find an answer to your question, please contact us. If your Traditional or Roth IRA contract allows for additional premium, your contribution must be sent to a company-approved mailing address and postmarked by the due date for filing your return for that year, not including extensions. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. Due to HIPAA regulations, we are unable to release your personal information without your authorization. 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. calpers long term form one-size-fits-all solution to design calpers continued monthly residence form? After January 31, you can check to see if your statements are also available online by registering or logging in to your account and going to Current Statements." We will mail Form 5498 by January 31, 2023. 1 hours ago The IRS requires the use of specific distribution codes for different types of payments, which need to be reported separately. Typically, a policy with three years of successful premiums paid acquires a surrender value. Minneapolis, MN 55440-0561 Choose My Signature. By registering your account online, you will have access to contract values, statements, the ability to change allocations, and access to yearly tax statements. Monday Thursday 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. PO Box 1344 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. Why does the Form 5498 show no contributions? Fixed annuities fixedannuity@send.allianzlife.com Variable Annuities Representative must be appointed with Allianz Life Insurance Company of North America. Allianz Global Investors is here to help. Allianz 222 Annuity provides the typical features of fixed index annuities including principal protection from market downturns, the potential for tax-deferred growth, options for lifetime retirement income, and a death benefit for your beneficiaries. If you believe that this page should be taken down, please follow our DMCA take down process here. Here you can find all the legal documents, forms and literature on our funds. Tax forms will be sent to the beneficiary in the year following payment if applicable. 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. You can call us to process an authorized debit of your bank account by phone. Get this form now! As a reminder, under the SECURE Act of 2019 individuals turning age 70 in 2020 are not required to begin taking RMDs until the year of attaining age 72 (first RMD due by April 1 of the year following the year of attaining age 72). The death benefit from a Roth IRA may be income tax free if certain requirements are met. What are you doing to ensure the safety of your employees? Upon receipt, the Allianz Claims department will evaluate your claim within 10 business days. Complete each fillable area. : (886) 2 8770 9888 Fax : 0800 088 112 . About Fixed Index Universal Life Insurance, Allianz Life Insurance Company of North America, Date of birth and/or Social Security number (SSN) of deceased. If you click a merchant link and buy a product or service on their website, we may be paid a fee by the merchant. A new withdrawal form is required with each request. Here are steps you can take to help protect yourself: Know when payments are due. If you received distributions from multiple contracts, you will get a 1099-R for each contract. pdfFiller is not affiliated with any government organization. The general limit the most that can be contributed to your Traditional IRA and/or Roth IRA is the lesser of the following amounts: $6,000.00 ($7,000.00 if you are age 50 or older) or your earned income for the year. A beneficiary is the person or entity that is entitled to the death benefit of the annuity contract or life insurance policy. My contract is annuitized; why am I receiving this annual tax summary? Change the blanks with smart fillable areas. What steps can I take to help protect myself from fraud and scams related to COVID-19? Producer Services 763.582.6005. A newly completed form is required for all requests. We do not currently accept payments through our website. Please note that online statements are not available for some clients. If they are negotiable, or you make an offer you can change? Typically, the Fair Market Value (FMV) in Box 5 is the only information provided. Please note that email notifications are not available for premium payment updates. You can Surrender Bajaj Allianz Life insurance policy online on our portal. I hereby authorize the Allianz Funds to provide copies of my monthly account statements to the individuals set forth below. A policy acquires surrender value when the policy is in force and the mandatory lock in period is completed. ", First log in, then click on the policy or contract number(s) displayed under "My Account. We encourage you to consult your tax and/or legal advisor with any related questions. 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." Please allow 5-7 business days to receive your statement(s) by mail. Allianz Life Insurance Company of North America (Allianz), its affiliated companies, and their representatives and employees do not provide legal or tax advice. Allianz Life Insurance Company of North America This form is required to verify the needs of the claimant. If you are covered by one of the International Healthcare Plans for Egypt, use this form to claim back eligible medical expenses. A+ (Superior) and A (Excellent) are the 2nd and 3rd highest, respectively, of A.M. Best's 13 . Life insurance 763.582.6002 If the Scheduled RMD indicates No," then RMD payments have not been set up on the contract being viewed. Use direct deposit to receive secure electronic payments. Employer contributions to a SEP IRA will be reported in Box 8. The Direction to Pay form is provided as a convenience to our policyholders and their care providers Claim Healthcare Form. Find the right form for you and fill it out: No results. 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). Prudential Global Beneficiary Designation Form. We will contact the beneficiary for additional information if needed. To submit a request for an eligibility determination, a claim form and additional information is required to initiate this 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. Any determination that is to be made, such as to policy values, beneficiary, claim eligibility, or policy status, will take place. Minneapolis, MN 55416-1297, Fax Claim Professional accountant Form. This email with intrauterine growth, and who renders the dtf oversees the web at calpers continued care program pays the. Create this form in 5 minutes! Its a good idea to contact your financial professional or issuing agent to review and determine the best options for your situation. Allianz receives document and process surrender. If you are covered by one of our GlobalPass plans for Latin America, choose the relevant form below to claim back eligible medical expenses. Email: longtermcareclaims@metlife.com office. In addition, we are making sure financial professionals who work with Allianz Life have access to collaboration technologies to stay connected with clients. Know your salesperson before you buy any financial product. We will be looking into this with the utmost urgency, The requested file was not found on our document library. Fax Form 5498 is also used to report the year-end Fair Market Value information for your annuity. Please consult a tax professional to determine this amount. Complete the blank fields; involved parties names, places of residence and phone numbers etc. Allianz to provide up to 12.5 million euros of humanitarian assistance. Apt. To get started on the form, use the Fill & Sign Online button or tick the preview image of the blank. If Need help bajaj allianz life insurance customer care number:1800 209 7272. Our Claims Informationpage will help you learn about the process and what information you will need to provide. 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. , 10476 378 5 Tel . 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? Annuities are classified into two basic types: tax-qualified and non-tax-qualified. Upon receipt of the required documents, we will process your claim within 10 business days or within the applicable state requirements. Under My Policy, select Withdrawal Funds, select Start, select Setup RMD payment schedule, and follow the prompts to complete the request. Why is the total distribution amount reported in Box 1 (gross distribution)? Fixed annuities 763.582.6002 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. signNow combines ease of use, affordability and security in one online tool, all without forcing extra DDD on you. RMD information is displayed on the Policy Detail screen under Accounts. I took receipt of money from another IRA and later placed it into this IRA at Allianz. 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. Employer contributions are required to be reported on the form for the year the contributions are received. Depending on the option selected, payment will be sent to the beneficiary. Application for Child Care Benefits - Ohio Department of Job and - jfs ohio. Get access to thousands of forms. Your death benefit options may differ according to the annuity contract or life insurance policy. If you had a taxable distribution in more than one resident state, a separate 1099-R would generate for each state. In times like these, financial matters may be the last thing on your mind. Non-individual owner name (Attach Non- Individual Ownership form or Qualified Will the annuity contract applied for replace or change existing contracts Samsung, on Our behalf, will service the Beneficiary's claim upon return to the United Kingdom where the Insured Product must have been purchased and Prudential Life Insurance : A summary about basic life policy offerings. You can also download it, export it or print it out. Where do I find my Form 1099-R statement? What is the difference between a tax-qualified and non-qualified annuity contract? Please follow the instructions on the form if you would like your policy premiums deducted automatically. Weve collected templates for parents, students, and teachers all in one place to save time. PO Box 59060 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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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.