ANICO
ANNUITY
- 10585-PR-Allocation (PDF)
- Absolute Assignment (PDF)
- Annuity Claim (PDF)
- Annuity Service Request (PDF)
- Deceased Ownership Change (PDF)
- Deduction Monthly Premiums from Salary 971 (PDF)
- Lifetime Income Rider Request (PDF)
- NON-ADMIN GROUP CONTRACT DISTRIBUTION REQUEST (QUALIFIED ANNUITY) (PDF)
- Pre 59 age Distribution Request (PDF)
- Request for Confinement, Disability or Terminal Illness Waiver Facility (PDF)
- Request for Confinement, Disability or Terminal Illness Waiver Owner (PDF)
- Request for Confinement, Disability or Terminal Illness Waiver Physician (PDF)
- Suitability-USA Patriot Act (PDF)
- Summary and Disclosure Notice for Accelerated Benefits (PDF)
- Transfer 1035 and Non Qualified (PDF)
- Transfer or Rollover Qualified Request (PDF)
- Waiver of Administrative Services (PDF)
- WealthQuest Series - Additional Payment Receipt - 4729 (PDF)
LIFE
- Absolute Assignment (PDF)
- Additional Beneficiary for Inforce Policies (PDF)
- Address-Contact Change and Policy Duplicate AN-11090 (PDF)
- ANICO Change of Agent (DOCX)
- Application for Policy Change (Term Conversion) (PDF)
- Application for Reinstatement ICC09582 (PDF)
- Beneficiary Change Request (PDF)
- Change of Ownership (PDF)
- Claim for Chronic Illness - Statement of Claimant (DOC)
- Claim Form for Chronic Illness Acc Ben Phy Statement (DOC)
- Collateral Assigment - AN331 (PDF)
- Death Claim AN536 (PDF)
- Declaration of Insurability (Increase IUL) (PDF)
- Deduction Monthly Premiums from Salary 971 (PDF)
- Payroll Deduction 969 (PDF)
- Policy Change Application - 11197 (PDF)
- Policy Loan or Cash Surrender Request 1158 (PDF)
- Policy Service Request AN11091 (PDF)
- Policy Service Request for Indexed Universal Life AN-11114 (PDF)
- Pre-Authorize Payment Plan Form 2011 (PDF)
- Transfer 1035 and Non Qualified 4394NQ (PDF)
- Transfer or Rollover Qualified Request 4394Q (PDF)
Fidelity & Guaranty
- 1035 Exchange Transfer - Rollover (PDF)
- Change Beneficiary Request (PDF)
- Change Name or Address (PDF)
- Claimant's Statement- Annuity (Non-Qualified) (Deceased) (PDF)
- Contract Change - Transfer of ownership (PDF)
- Distribution Request By Beneficiary (PDF)
- Duplicate Policy Request (PDF)
- Fidelity Change of Agent (DOCX)
- Request for disbursement form Qualified Annuities (all Non-NY States) (PDF)
- Request for Disbursement - Non-Qualified Annuities (PDF)
- Signature Verification Form (PDF)
- W-9 Request Taxpayer Identification Number and Certification (PDF)
John Hancock
Lincoln Financial Group
ANNUITY
- 1035 Exchange-Rollover (PDF)
- Additional Deposit
- Annuity Automatic Withdrawal Non Qualified (PDF)
- Annuity Change Broker-Representative (PDF)
- Automatic Bank Draft (PDF)
- Certification of Trustee Powers (PDF)
- Change of Agent (PDF)
- Change of Ownership for Annuity (PDF)
- Change Beneficiary (PDF)
- CLAIMANT'S STATEMENT UP LIFE DEATH (PDF)
- Collateral Assignment Life or Annuity (PDF)
- Contract Change Request (PDF)
- DECEASED CONTRACT REQUEST (PDF)
- Direct Deposit Authorization (EFT) (PDF)
- Distribution Request - Guaranteed Lifetime Withdrawal Benefit Rider (PDF)
- Distribution Request - NONQUALIFIED NOT LIVING BENEFITS (PDF)
- Non Qualified Claimant's Statement (PDF)
- Producer Information Change (PDF)
- Release Collateral Assignment Life or Annuity (PDF)
- Repayment of Coronavirus Related Distributions (PDF)
LIFE
- 1035 Exchange (PDF)
- Agent Change (PDF)
- Allocation Change or Transfer Request (PDF)
- Application for Conversion-PR (PDF)
- Beneficiary Change for Life (PDF)
- Cancel Letter 1035 (DOC)
- Collateral Assignment Life or Annuity (PDF)
- Contract Change Request (PDF)
- Life Address Change Form (PDF)
- Loan Request (PDF)
- Lost Policy - Duplicado de Póliza (PDF)
- Name Change (PDF)
- Ownership Change - Life (PDF)
- PAC Electronic Fund Transf. Auth. (PDF)
- Partial Surrender or Withdrawal - Life (PDF)
- Premium Deposit Fund Transmittal (PDF)
- Producer Information Change (PDF)
- Reinstatement or Change App (PDF)
- Release Collateral Assignment Life or Annuity (PDF)
- Release Collateral Life or Annuity (PDF)
- Surrender Request - Life (PDF)
- Systematic Disbursements (PDF)
- Term Cancellation Request (PDF)
Mass Mutual
National Western
- Additional Beneficiary (PDF)
- Address Change Request (PDF)
- Annuity Death Claim (PDF)
- Assignment Policy as Collateral (PDF)
- Change of Beneficiary (PDF)
- Direct Deposit Request (PDF)
- Early Distribution (PDF)
- Early Distribution Transfer (PDF)
- Minimum Distribution Disclosure Age 70 and Older (PDF)
- Partial Surrender (PDF)
- Policy Owner Change Request (PDF)
- Request for Systematic Withdrawal of Interest (PDF)
- Request Q-NQ Spousal Continuation (PDF)
- Request Systematic Payment (PDF)
- Request Systematic Payment under Rider (PDF)
- Surrender Form (PDF)
- Systematic Payment Penalty Free (PDF)
- W-9 Identification Form (PDF)
Ohio National
Protective
- Allocation Change (PDF)
- Application for Conversion or Exchange (PDF)
- Assignment Transfer (PDF)
- Automatic Premium Loan (PDF)
- Beneficiary Change (PDF)
- Change of Name (PDF)
- Collateral Assignment (PDF)
- Duplicate Policy (Policy Lost) (PDF)
- Duplicate Policy (Policy Not Lost) (PDF)
- Loan Request (PDF)
- Partial Assignment of Policy as Collateral (PDF)
- Partial Surrender (PDF)
- Pre-Authorized Withdrawal (PDF)
- Reinstatement for PR (PDF)
- Service Request (PDF)
OTROS
- CANCELACIÓN TERM (DOCX)
- Carta Cancelación de Annuity (DOCX)
- Carta Cancelación de Pólizas (DOCX)
- Carta Cancelación Descuento Sueldo Póliza (DOCX)
- Change of Agent (DOCX)
- COVID-19 CARTA PARA CESAR PRIMAS (DOCX)
- Directorio Servicio al Cliente (PDF)
- Life & Annuity Proposal Request Fillable (PDF)
- Requisitos Reactivación & Licencia Nuevas OCS (PDF)
- Requisitos Renovación de Licencia OCS (PDF)