Service forms library: Variable Annuity
To download a Service Form on your policy, please click on the appropriate form name. Please mail your completed form to:
Variable Products Service Center
Madison Square Station
P.O. Box 922
New York, NY 10159
Note: You must have Adobe Acrobat Reader to view these files. If you do not have this, please visit the Adobe Website to install Adobe Acrobat Reader.
Automatic Asset Reallocation and Dollar Cost Averaging Form
Use this form to choose Automatic Asset reallocation or Dollar Cost Averaging. (See instructions on form)
Change of Allocation & Funds Transfer Form
Use this form to change how future payments are applied or to transfer amounts from one allocation alternative to another.
Change of Beneficiary Form
Use this form to change the beneficiary on your policy. Do not use this form if your policy is a family plan or if it has rider insureds.
Statement of Trust Form
Use this form to change the beneficiary or ownership of your policy to a Trust.
Check-O-Matic (C-O-M) Request Form
Use this form to set up a payment arrangement in which premiums are paid monthly by automatically deducting the money directly from your checking account.
Dollar Cost Averaging (DCA) Advantage Form
Use this form to select LifeStages 6 month, 12 month, or 18 month. If a portion of your premium is to be allocated to Investment Divisions and/or Fixed Account, in addition to the DCA Advantage Plan, complete the Change of Allocation and Transfer Form.
Interest Sweep Form
Use this form to elect the Interest Sweep option. This option provides for the interest earned on monies allocated to the Fixed Account to be transferred from the Fixed Account to any combination of Investment Divisions.
Periodic Partial Withdrawal / Partial Withdrawal Request Form
Use this form to make a Partial Withdrawal or set up or modify an automated Periodic Partial Withdrawal Arrangement. To make a partial withdrawal from a Tax-Sheltered Annuity, please contact a Customer Service Representative at (800) 598-2019.
Telephone Authorization Form
Use this form to initiate telephone authorization to access information and/or process transactions over the telephone.
Transfer of Ownership / Designation of Successor Owner Form
Use this form to request a transfer of ownership and/or designate a successor owner.
Transfer of Ownership Kit
Use this kit to transfer ownership, setup a Check-O-Matic arrangement to pay your premiums, and change your beneficiary
IRS Form W-4P - Withholding Certificate for Pension or Annuity Payments
If you are a US person, use this form for all annuity contracts and annuity death claims.
IRS Form W-9 - Request for Taxpayer Identification Number and Certification
If you are a US person, use this form to: certify that the Taxpayer Identification Number (TIN) you are giving is correct (or you are waiting for a number to be issued); certify that you are not subject to backup withholding; or claim exemption from backup withholding if you are a U.S. exempt payee.
If you are a non US citizen residing abroad or a Foreign Entity, use the appropriate form below for annuities, death claims, change of ownership or to refresh information on our files.
Instructions for the Form W-8BEN
Instructions to complete the IRS Form W-8BEN.
Instructions for the Form W-8BEN-E
Instructions to complete the IRS Form W-8BEN-E.
Instructions for the Form W-8ECI
Instructions to complete the IRS Form W-8ECI.
Instructions for the Form W-8EXP
Instructions to complete the IRS Form W-8EXP.
Instructions for the Form W-8IMY
Instructions to complete the IRS Form W-8IMY.
To obtain additional Service Forms or to request certain transactions on your policy, please contact a Customer Service Representative at (800) 598 - 2019.