Designates a third party to receive information on a life insurance policy. Used in all states except NY.
eShip # | Form Name | Select |
160964 | Use to request an increase in face amount, the addition of a rider or an improved premium class. For reinstatements of a VUL policy, use form 175037. | |
131287 | Used to change a beneficiary designation on a life insurance policy. | |
128623 | Use in all states to set up automatic payment of premiums from a customer's bank account. | |
211842 | Use to request an increase in face amount, the addition of a rider or an improved premium class. Approved in DE, GU, ND and SD. | |
211844 | Use to request an increase in face amount, the addition of a rider or an improved premium class. | |
211846 | Use to request an increase in face amount, the addition of a rider or an improved premium class. | |
211840 | Use to request an increase in face amount, the addition of a rider or an improved premium class. In Puerto Rico use for term and UL policies only. | |
212951 | Use to request an increase in face amount, the addition of a rider or an improved premium class. | |
131355 | Used to request change of name, address, premiums, nonforfeiture options, dividend options and non-underwritten coverage changes in all states. |
eShip # | Form Name | Select |
131455 | Used to assign a policy as collateral in all states. | |
114079 | Use this form to notify Voya of a legal name change, address change or change to a trustee. | |
131456 | Allows assignee to release all rights to a policy currently assigned to them. | |
131538 | Allows a policyowner to transfer ownership to another entity/person. This will not be considered in good order without a W-9 form completed by the new owner. Used in all states. | |
172765 | Use this form for in force policies where a Trust is the owner or primary beneficiary of a life insurance policy. The Trustee(s) and the Grantor/Settlor should complete and execute this form. The Grantor/Settlor is the creator of the trust. |
eShip # | Form Name | Select |
211852 | Use to apply for reinstatement of a recently lapsed life insurance policy in California. | |
211850 | Use to apply for reinstatement of a recently lapsed life insurance policy. | |
211854 | Use to apply for reinstatement of a recently lapsed life insurance policy. | |
211848 | Use to apply for reinstatement of a recently lapsed life insurance policy. Use only for term and UL policies in Puerto Rico. | |
212949 | Use to apply for reinstatement of a recently lapsed life insurance policy. | |
211806 | Use to apply for reinstatement of a recently lapsed life insurance policy. | |
211822 | Use to apply for reinstatement of a recently lapsed life insurance policy. |
eShip # | Form Name | Select |
136179 | Use to request a loan on a 403(b) policy. |
eShip # | Form Name | Select |
131394 | Used to request surrender of a life insurance policy. |
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Table of contents, key takeaways.
If you'd like to borrow money through a loan, life insurance could help you qualify and get a lower interest rate. Through something called a collateral assignment of life insurance, you can set up an agreement where your policy pays the lender in case you can't.
Not every lender accepts this arrangement, and there are downsides, notably that your primary beneficiary is no longer first in line for the life insurance death benefit. However, in the right situation, it can be a useful financial strategy. Here's what to know about an assignment of life insurance and how to use it properly.
Collateral is a valuable asset that can be used to secure a loan. When you borrow money, you legally agree to repay the lender, usually with scheduled payments and interest. But the lender is taking a risk that you won't pay them back.
When you put up collateral, the lender can legally take that asset if you don't pay back the debt. Real estate, vehicles, equipment and investment accounts are common examples of loan collateral.
In a collateral assignment of life insurance, you use a life insurance policy to secure a loan. You first set up coverage as usual by applying for and buying some type of life insurance policy with a death benefit. If you already have a policy, you could use that too.
Then you fill out a collateral assignment form with the lender. This gives them the right to use the life insurance benefits to pay themselves back if you don't pay off their loan. This could happen if you default or if you happen to die before paying off the debt. With this assignment, you've agreed to use the life insurance death benefit to pay off the remaining loan balance first.
You'll still select a primary beneficiary , the person or entity you want to receive the insurance payout. But with a collateral assignment, if you die without paying off the loan, the life insurance death benefit pays off the debt first. Only if there's any remaining benefit amount does it go to your listed beneficiary. Once you pay off the debt, the assignment ends, and the life insurance would pay your beneficiary in full as usual.
It depends on what the lender is willing to accept. In theory, you could use any type of life insurance for this arrangement. However, some lenders may only accept permanent coverage, such as whole life or universal life . The reason is that permanent coverage doesn't expire as long as you or the lender make the premium payments. As a result, the lender can make sure they eventually collect the death benefit by making the premium payments themselves (they would add this cost to your outstanding debt). Another reason lenders may prefer permanent life insurance is because it can build cash value, a reserve of money while you're alive. This is another valuable asset the lender could take as repayment.
On the other hand, term life insurance has a set expiration date. If you outlive the term, the coverage ends. While a lender could accept term life insurance as collateral, they take on the risk that you both fail to pay off the loan and outlive the term. In this case, the lender would lose their collateral and won't be certain to get their money back.
Hypothetical scenarios may help better illustrate how life insurance can be used as collateral. Here are two examples to consider:
While the exact process for setting up this arrangement will depend on your lender and insurer, there are a few common steps. Here are five actions you could take:
You can ask your lender whether they allow a collateral assignment of life insurance. If so, check what they require for this arrangement. For example, do they allow all types of life insurance policies or only certain ones, like whole life ? If you have an existing policy, would they accept it for the assignment? Or would you need to buy a new policy for this arrangement?
If you already have life insurance and your insurer is willing to accept it, you could use it for the collateral assignment. If you don't have life insurance or your death benefit isn't large enough, you would need to purchase another policy. Be sure to ask your lender whether they only work with certain life insurance companies.
Contact your life insurance company for a collateral assignment form. This form lists information about your loan, such as the amount, the repayment schedule and the lender. Once you and your lender sign this form, your insurer can officially add the lender as the collateral assignee for your policy.
With your collateral assignment in place, you and the lender would then complete the loan application process. Once you get approved, they would send you the loan funds, secured using your life insurance.
You would pay off your debt according to the lenders' payment schedule. Once you've made the final payment, you would contact your life insurance company to let them know. They would confirm with your lender and then end the collateral assignment. From that point on, the death benefit would go to your primary beneficiary, not to the lender.
Optimize your financial strategy by using life insurance as a valuable collateral asset. Get a Life Insurance Quote
A collateral assignment of life insurance can make sense if you already have life insurance or you are healthy enough to qualify for a new policy. It also could be worth using if you have addressed your life insurance needs already. Lastly, this arrangement can make sense if you don't want to risk your other assets or if you don't have any other assets for collateral.
If you don't have life insurance and don't think you could qualify for a new, affordable policy because of health issues, this approach might not be an option. If you have life insurance but don't want to risk not having enough coverage for your beneficiaries, this approach also might not be worth it.
To decide if this approach may be right for you, consider speaking with a financial professional . They can compare your other borrowing options and offer guidance based on your specific needs. If a collateral assignment is the best move, they can also help you with your insurance application.
Evaluate if using life insurance as collateral aligns with your financial goals. Get a Life Insurance Quote
Information provided is general and educational in nature, and all products or services discussed may not be provided by Western & Southern Financial Group or its member companies (“the Company”). The information is not intended to be, and should not be construed as, legal or tax advice. The Company does not provide legal or tax advice. Laws of a specific state or laws relevant to a particular situation may affect the applicability, accuracy, or completeness of this information. Federal and state laws and regulations are complex and are subject to change. The Company makes no warranties with regard to the information or results obtained by its use. The Company disclaims any liability arising out of your use of, or reliance on, the information. Consult an attorney or tax advisor regarding your specific legal or tax situation.
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RESET FORM ASSIGNMENT OF LIFE INSURANCE POLICY AS COLLATERAL ReliaStar Life Insurance Company, Minneapolis, MN ReliaStar Life Insurance Company of New York, Woodbury, NY Security Life of Denver Insurance.
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It will take seven to 10 days on average to receive the funds when you cash out your 401(k).
Depending on who administers your 401(k) account (typically a brokerage, bank or other financial institution), it can take between 3 and 10 business days to receive a check after cashing out your 401(k).
There are many types of withdrawals available through the Plan: De Minimis, Unforeseen Emergency, Purchase of Service Credits, Partial Termination Withdrawal, and Full Termination Payout.
To access your account by phone 24 hours a day, seven days a week, call the Retirement Readiness Service Center at (800) 584-6001 and press 1 for the automated voice response system. You will need your Social Security Number and PIN to utilize this system.
Opting for Direct Deposit You will still need to wait for your withdrawal application to process which takes five to seven days on average before the funds are released into your account.
The withdrawal may be made between the 3rd and the 28th only, and will occur on the 20th if no selection is made. Exact date may vary one or two days. NOTE: Due to your bank's requirements, please allow up to 30 days for the electronic bank link to begin. Transamerica Funds.
After the signed form is received and approved by Voya Financial®, a check will be mailed within three business days. Separated participants can receive distributions no earlier than 45 days from their termination date.
A collateral assignment of life insurance is a conditional assignment appointing a lender as the primary beneficiary of a death benefit to use as collateral for a loan. If the borrower is unable to pay, the lender can cash in the life insurance policy and recover what is owed.
Definition: An absolute assignment is the act of complete transfer of the ownership (all rights, benefits and liabilities) of the policy completely to other party without any terms and condition. Description: Absolute assignment shifts the ownership of the insurance policy.
You can request a withdrawal online at VoyaRetirementPlans.com, or call a Voya Customer Service Associate at (800) 584-6001.
Voya corporate variable universal life - sec.gov.
May 1, 2016 — Is issued by Security Life of Denver Insurance Company. ... the Voya...
Voya Employee Benefits is a division of ReliaStar Life Insurance Company. ... Collateral...
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Form # | Form Name | Description |
VL 13535 | Used to grant account access to individuals as named by the client or to establish a Client Care Center password on the clients account. PDF only. | |
VL 14945-2 | Used to submit additional designations of beneficiaries who are minors. Must submit with VL 14945 or application or enrollment form. PDF only. | |
VL 14945-1 | Used to submit additional beneficiary designations that exceed space allotted on VL 14945 or application forms. Must submit with VL 14945 or application form. PDF only. | |
VL 15169 | Used to submit administrative changes to a client account. Changes include name, SSN, address, telephone, date of birth, NQDA ownership and delivery option election. | |
VL 14945 | Used to submit annuity beneficiary designations. Spousal signature notarized or witnessed by a Plan Administrator required for ERISA accounts when a non-spouse is designated as primary beneficiary for more than the allowable percentage under the plan. | |
VL 23015 | The form is required when submitting nonqualified applications where the ownership is a Trust. The form will also be required for subsequent NQDA ownership changes where the new owner is a Trust. | |
VL 23547 | Used and submitted with every Entity, Trust, or any Non-Individual Organization application for VFA and VALIC and VALIC Transfer Rollover Exchange, except VALIC Group Enrollments. | |
VL 100 | Used to submit administrative changes to a client account. Changes include beneficiary change, address, name and duplicate contract request. | |
VL 18546 | Used to describe the forms needed to complete transactions involving External Broker Dealers selling VALIC products. | |
VL 19725-457 | Use to provide additional information for distributions for - military reservists called to active duty, health, long-term care or accident insurance for retired public safety officers, or hardship or UEWs for certain beneficiaries of 457 plans | |
VL 23547-1 | Used to submit additional Trust Donors Trustees or managers and beneficiaries that exceed space allotted on VL 23547 Entity Client Account Form. Must submit with VL 23547. | |
VL 897 | Used when a Power of Attorney related request is being made. This form is used with all VALIC products. | |
VL 22415 | Used to submit beneficiary designations changes for Profile or Inside Edge Accounts only. |
VL 6730 |
| Used by a client to authorize VALIC to transfer funds to a bank account as specified by the client. PDF only. |
VL 250 |
| Used to select the type, annuity benefit, and payment frequency. Note- once selected, the annuity option is irrevocable. This form is used for POWER Index, and Assured Choice (available for Independent Channel Only) |
VL 151 |
| Used to initiate the minimum distribution as required by the IRS. This form is used for POWER Index, and Assured Choice which is available in Independent Channel Only. |
VL 175 |
| Used to request a direct Rollover of Funds to a new plan type from another Carrier to VALIC. This form is used for POWER Index, and Assured Choice available for Independent Channel. This form is also used for American Pathway Elite products within Forms Bundling. |
VL 163 |
| Used to request a partial withdrawal and assignment of proceeds under section code 1035a. This form is used for POWER Index and Assured Choice - available for Independent Channel. |
VL 102FI |
| Used to transfer money into the same plan type for 1035 exchanges. This form is used for Assured Choice(available in Independent Channel Only), Power Index, and American Pathway Elite products. |
VL 217 |
| Used to request an agreement or to change or cancel an existing agreement allowing for the preauthorized debit of systematic premiums. This form is used for POWER Index, and Assured Choice (available for Independent Channel Only) |
FA5550DSW |
| Used to establish a systematic withdrawal of a designated amount and frequency. This form is used for POWER Index and Assured Choice (available in Independent Channel Only). |
VL 162 |
| Used to request a partial or full cash withdrawal from an annuity contract other than 403(b). Thisa form is used for POWER Index, and Assured Choice (available in Independent Channel Only) |
VL 162A |
| Used to request a partial or full cash withdrawal from a 403(b) plan only. This form is used for Assured Choice (available in Independent Channel Only) |
VL 18546 |
| Used to describe the forms needed to complete transactions involving External Broker Dealers selling VALIC products. |
VL 19725-457 |
| Use to provide additional information for distributions for - military reservists called to active duty, health, long-term care or accident insurance for retired public safety officers, or hardship or UEWs for certain beneficiaries of 457 plans |
VL 897 |
| Used when a Power of Attorney related request is being made. This form is used with all VALIC products. |
VL 316-Roth |
| Used to request an internal Roth IRA conversion of an existing account for American Pathway Elite 4 and 7. |
VL 12837 |
| Used to make a withdrawal of funds from 457 plans for unforeseeable emergencies. |
VL 22551 |
| Used to initiate a Section 1035 Exchange In from an outside carrier to a VALIC account. Send forms directly to Home office for processing. Home office will obtain signoff on suitability from Regional Compliance Analyst. |
VL 6201 |
| Used to select a Payout option (payment frequency and method) when annuitizing a clients account. |
VL 8725 |
| Used to initiate distribution of a partial withdrawal, maximum withdrawal or full surrender. |
VL 995 |
| Used by a beneficiary to claim proceeds from a participants account after death. |
VL 9006 |
| Used to request account combination (different group,plan,subgroup to one account) or internal rollover from one VALIC account to another. For product exchanges use VL9034. Minimum Distribution required prior to rollover if client has attained age 70.5. |
VL 5320-MAINT |
| Used for changes to an existing periodic payment associated with a Required Minimum Distribution (RMD) only. |
VL 5320 |
| Used to initiate the minimum distribution for group sponsored plans clients only as required by the IRS. |
VL 5320-EZ |
| Used for RMD set ups for group sponsored plans only clients where VALIC calculated, pro-rata, multi-year automatic recurring payments. Use RMD Maintenance Form for making changes to an existing RMD. Use Beneficiary Distribution form for beneficiary distributions. Do not use this form for IRA plans. |
VL 5320-IRA |
| Used for RMD set ups for IRA only clients where participant calculates RMD payment, prior year payments, non pro-rata fund selection, joint life expectancy calculation, reinvestment into an existing nonqualified deferred annuity. Use RMD Maintenance Form for making changes to an existing RMD. Use Beneficiary Distribution form for beneficiary distributions. Do not use this form for group sponsored plans. |
VL 5320-IRA-EZ |
| Used for RMD set ups for IRA only clients where VALIC calculated, pro-rata, multi-year automatic recurring payments. Use RMD Maintenance Form for making changes to an existing RMD. Use Beneficiary Distribution form for beneficiary distributions. Do not use this form for group sponsored plans. |
VC 26126 |
| Used to assist clients in understanding Fixed and Fixed Index Annuities in the following states AL AK AR AZ CO FL GA HI IA ID KY ME MO MT NV NJ NM NC OH OK OR RI SC UT WI and WV. Also required in AL, CO, FL, GA, IA, ME, MO, NH, OH, RI, TX, WI, and WV for Variable Annuities. Must be provided to clients at time of application for the following plan types only IRA, Roth IRA, SEP, Simple IRA and NQDA. Use appropriate guide based on client's state of residence. New Hampshire requires the NAIC buyers guide effective 4/30/2018 with 60 day implementation extension period to 6/30/2018. |
VL 11411 |
| Used to provide additional fund selection space as an addendum to Application, Enrollment, Internal Combination or Rollover and Combined Enrollment or Exchange forms. PDF only. |
VL 28668 |
| Used when the client has an IRA account and wants to send distribution payments to a qualified 501(c)(3) organization that is eligible to receive tax deductible contributions. Must be used with another VALIC distribution form. |
VL 8715 |
| Used to transmit an additional contribution for a client and for providing the client with a receipt. Complete only as needed. |
VL 25190 |
| Used by the Independent Channel to transmit an additional contribution for a client and for providing the client with a receipt. Complete only as needed. |
VL 25031 |
| Used exclusively by external broker-dealers to liquidate Nonqualified or Non-Insurance accounts and transfer funds to VALIC. |
VL 8725-C SONJ |
| Used to initiate distribution of a partial withdrawal, maximum withdrawal or full surrender. |
VL 20795 |
| Used to establish a systematic withdrawal of a designated amount, designated number of years or substantially equal payments. Version 10-2002 includes the Fixed Interest Only option feature and allows for fund selection. Use form VL 20795-LB if the account has a living benefit. |
VL 20795-LB |
| Used for accounts with living benefits to establish a systematic withdrawal of the MAWA or a designated amount less than tor equal to the MAWA. This form should only be used for accounts with living benefits. Use form VL 20795 if the account does not have a living benefit. |
VL 18484 |
| Used exclusively by external broker-dealers to transfer-rollover in funds for ALL PLAN TYPES from a client account at another carrier to VALIC. |
VL 22140 |
| Used to request withdrawal or distribution for funds for hardship reasons. |
VL 600-FA |
| Used to submit an administrative change of ownership to a client account. |
VL 23764 |
| Used for the following (must be same ER group and Plan )-Roll existing VALIC assets to a designated Roth VALIC acct-Roll existing VALIC assets to a designated acct at another provider-Roll assets from another plan provider to a VALIC designated Roth acct. |
VL 23554 |
| Used with Premiere 5 and 7, Power Index and (Proflex Independent Channel only) products, to provide proof of extended care in order to waive the contracts early withdrawal charge. |
VL 23767 |
| Used with Power Index and (Proflex Independent Channel only) products, to provide proof of terminal illness in order to waive the contracts early withdrawal charge. |
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|
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VL 18484 |
| Used exclusively by external broker-dealers to transfer-rollover in funds for ALL PLAN TYPES from a client account at another carrier to VALIC. |
VL 26991 |
| Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459. |
VL 26991-FL |
| Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 for FLorida only. |
VL 26991-NJ |
| Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 for New Jersey only. |
VL 26991-NY |
| Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile.For use in New York only. Replaces VL 25459 NY only |
VL 26991-VA |
| Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459-VA. |
VL 26991 (406) |
| VALIC Fixed Annuity-406 application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 (406). |
VL 26991-FL (406) |
| VALIC Fixed Annuity-406 application. For use in Florida only. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459(406) in Florida Only |
VL 26991-NJ (406) |
| VALIC Fixed Annuity-406 application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459(406) in New Jersey. |
VL 26991-NY (406) |
| VALIC Fixed Annuity-406 Allocation. For use in New York only. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 NY only (406) |
VL 26991-VA (406) |
| VALIC Fixed Annuity-406 Allocation. For use in Virginia only. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459-VA (406). |
VL 23765-IC |
| Used when enrolling clients in Group or Individual Annuity products in the state of New York - informing the client regarding VALICs policy of compensating its insurance producers and their role in offering insurance products. Independent Channel. |
VL 21719 |
| Inside Edge Mutual Fund Employee enrollment form for IRA enrollment. |
SEE REPLACEMENT TAB |
| See Replacement Tab for access to State Replacement Forms. |
VL 259 |
| Required for all VALIC annuity products (fixed, variable, qualified and nonqualified ) being sold to clients who reside in CA and are 65 years of age or older if the product is being sold on the basis of its treatment under the CA Medi-Cal program. |
VL 14131 |
| Used when replacing life insurance products, including annuities and with all new business in the following states. AL-AR-AK-AZ-CO-CT-HI-IA-KY-LA-MD-ME-MO-MS-MT-NC-NE-NH-NJ-NM-OH-OR-RI-SC-SD-TX-UT-VT-WI-WV. Replacement |
VL 22059 |
| This disclosure form is required if the client has answered YES to being an active duty service member of the United States Armed Forces for all individual non-qualified and IRA applications. |
VL 22305 |
| Used to grant account access to Agents as named by the client or to establish a Contact Center password on the clients account. PDF only. |
VL 22415 |
| Used to submit beneficiary designations changes for Profile or Inside Edge Accounts only. |
VL 22583 |
| Required to establish Investment Advisory Services on a VALIC client account(s). |
VL 23303 |
| Used to open an IRA-Roth IRA in the name of a Minor. Affiant agrees to indemnify VALIC, including its agents, employees, successors, and assigns from every claim, demand or suit brought against them. |
VL 23431 |
| Used to establish Independent Channel accounts. Must be completed and submitted with every application, VALIC transfer, rollover, exchange, except VALIC group enrollments in a variable product. Distribute form copies as noted in the legend at bottom. |
VL 23479 |
| Used to authorize a reduction or termination of a salary reduction agreement for Traditional and Roth IRAs. |
VL 25031 |
| Used exclusively by external broker-dealers to liquidate Nonqualified or Non-Insurance accounts and transfer funds to VALIC. |
VL 25190 |
| Used by the Independent Channel to transmit an additional contribution for a client and for providing the client with a receipt. Complete only as needed. |
VL 26470-A |
| Required for all Florida transactions when purchasing a fixed annuity product regardless of how it is funded. Signature pages must be signed. Replaces VL 22982-A |
VL 26470-B |
| Required for all Florida transactions when purchasing an annuity product and the source of the money is another annuity. Signature pages must be signed. replaces VL 22982-B |
VL 28103 |
| Used when replacing life insurance products, including annuities and with all new business in Virginia. |
VC 26126 |
| Used to assist clients in understanding Fixed and Fixed Index Annuities in the following states AL AK AR AZ CO FL GA HI IA ID KY ME MO MT NV NJ NM NC OH OK OR RI SC UT WI and WV. Also required in AL, CO, FL, GA, IA, ME, MO, NH, OH, RI, TX, WI, and WV for Variable Annuities. Must be provided to clients at time of application for the following plan types only IRA, Roth IRA, SEP, Simple IRA and NQDA. Use appropriate guide based on client's state of residence. New Hampshire requires the NAIC buyers guide effective 4/30/2018 with 60 day implementation extension period to 6/30/2018. |
VC 22966 |
| Used in the state of Kentucky to assist clients in determining their insurance needs and the products related. Must be provided to the client. |
VL 22107 |
| Inside Edge Mutual Fund Employee Enrollment form for 401(a) enrollment. |
VL 3526 |
| Used to authorize a reduction of salary to fund a Section 403(b) plan. SRA |
VL 3526-ROTH |
| Used to authorize a reduction of salary to fund a Section 403(b) plan with ROTH deferral available. |
VL 14118-ROTH |
| Used to authorize a salary reduction and deferral of compensation for groups offering both plans to employees with ROTH deferral available. |
VL 14118 |
| Used to authorize a salary reduction and deferral of compensation for groups offering both plans to employees. Plan must offer both plans to use this form. |
VL 21555 |
| Inside Edge Mutual Fund Employee enrollment form for 403(b) enrollment. |
VL 21679 |
| Inside Edge Mutual Fund Inidividual 403(b) Custodial Account Agreement. This document must be provided to individual at application. |
VL 4546 |
| Used to authorize a deferral of salary to fund a 401(k) plan. |
VL 4546-ROTH |
| Used to authorize a deferral of salary to fund a 401(k) plan with ROTH deferral available. |
VL 21555-TX |
| Inside Edge Mutual Fund Employee enrollment form for 403(b) enrollment for use in Texas only. |
VL 8495 |
| Used for a client to defer compensation pursuant to the Employees Deferred Compensation Plan. |
VL 8495-ROTH |
| Used for a client to defer compensation of a 457(b) Governmental plan pursuant to the Employees Deferred Compensation Plan. |
VL 21680 |
| Inside Edge Mutual Fund Individual 457(b) Custodial Account Agreement. This document must be provided to individuals at application. |
VL 21706 |
| Inside Edge Mutual Fund Employee Enrollment form for 457(b) enrollment. |
VL 21706-TX |
| Inside Edge Mutual Fund Employee Enrollment form for 457(b)Enrollment for use in Texas only. |
VL 26991 |
| Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459. |
VL 26991-NJ |
| Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 for New Jersey only. |
VL 26991-FL |
| Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 for FLorida only. |
VL 14118 |
| Used to authorize a salary reduction and deferral of compensation for groups offering both plans to employees. Plan must offer both plans to use this form. |
VL 14118-ROTH |
| Used to authorize a salary reduction and deferral of compensation for groups offering both plans to employees with ROTH deferral available. |
VL 21680 |
| Inside Edge Mutual Fund Individual 457(b) Custodial Account Agreement. This document must be provided to individuals at application. |
VL 26996 |
| Proflex FLEXPDFA will close for new applications - sales in all states. The product will remain open for certain groups in IL and KS until a replacement product can be determined. Replaces VL 25456 |
VL 16377 |
| Used to establish electronic fund transfers for IRAs, non qual tax deferred annuities (NQDAs) SEPs. |
VL 14118 |
| Used to authorize a salary reduction and deferral of compensation for groups offering both plans to employees. Plan must offer both plans to use this form. |
VL 14118-ROTH |
| Used to authorize a salary reduction and deferral of compensation for groups offering both plans to employees with ROTH deferral available. |
VL 11411 |
| Used to provide additional fund selection space as an addendum to Application, Enrollment, Internal Combination or Rollover and Combined Enrollment or Exchange forms. PDF only. |
VL 10330 |
| Used to authorize salary reductions for SIMPLE 401(k) plans. PDF only. You are responsible for distributing copies as noted in the distribution legend at the bottom of the form. |
VL 23180 |
| Required by the Texas Retirement System. This form must accompany any new K-12 403(b) applications for a Series 1 contract. For Independent Channel use only. |
VL 23181 |
| Required by the Texas Retirement System. This form must accompany any new K-12 403(b) applications for a Series 5 contract. For Independent Channel use only. |
VL 14945-1 |
| Used to submit additional beneficiary designations that exceed space allotted on VL 14945 or application forms. Must submit with VL 14945 or application form. PDF only. |
VL 7897 |
| Used only in Florida when replacing life insurance products including annuities funded through values in existing enforce policy with same insurer Instructions on cover page Obtain submit replacement form to expedite processing by redeeming carrier. |
VL 10402 |
| Salary Reduction Agreement for SIMPLE IRA plans. PDF only. You are responsible for distributing copies as noted in the distribution legend at the bottom of the form. |
VL 12667-NY IC |
| Used exclusively in New York by Independent Channel Broker-Dealers when replacing an individual annuity or other insurance products. Instructions for distribution of copies and materials are on the cover page of the form. Replacement. PDF includes VL 19176 Authorization To Disclose Information - NY Reg 60 |
VL 12669-NY IC |
| Used exclusively in Ney York by Independent Channel Broker Dealers when replacing an individual annuity or other insurance products. Instructions for distribution of copies and materials are on the cover page of the form. Replacement. |
VL 12670-NY IC |
| Used exclusively in New York by the Independent Channel Broker Dealer when replacing an individual annuity or other insurance products. Instructions for distribution of copies and materials are on the cover page of the form. Replacement. |
VL 19176-IC |
| Used exclusively in NY when replacing an individual annuity or othr insurance products to authorize current carrier to release information necessary to complete attached forms pursuant to NY Reg 60. Replacement. PDF includes VL 12667-IC NY Replacement Form for New York - NY 10A |
VL 26995 |
| Used by Independent Channel to enroll participants in a qualified GROUP contract. Use state specific for FL, NJ, NY and VA. PDF includes Application and Agent Access. The OA is required in all states. Replaces VL 26443. |
VL 26995-FL |
| Used by Independent Channel to enroll in a qualified GROUP contract in Florida. Use state specific for NJ, NY and VA. PDF includes Application and Agent Access. The OA is required. Replaces VL 26443-FL. |
VL 26995-NJ |
| Used by Independent Channel to enroll participants in a qualified GROUP contract in New Jersey. PDF includes Application and Agent Access. Replaces VL 26443-NJ |
VL 26995-NY |
| Used exclusively by Independent Channel in New York State only to enroll participants in a qualified GROUP contract. Enrollment. PDF includes Owner Acknowledgement and Agent Access forms. Replaces VL 26443-NY |
VL 26995-VA |
| Used by Independent Channel to enroll in a qualified GROUP contract in Virginia. PDF includes Application and Agent Access. Replaces VL 26443-VA. |
Form # | Form Name | Description |
VL 23562 |
| Used in Arkansas for all Individual and Group Annuity contracts when replacing an Individual Fixed Deferred Annuity. Replacement Memorandum must be completed at the point of sale. |
VL 14131 |
| Used when replacing life insurance products, including annuities and with all new business in the following states. AL-AR-AK-AZ-CO-CT-HI-IA-KY-LA-MD-ME-MO-MS-MT-NC-NE-NH-NJ-NM-OH-OR-RI-SC-SD-TX-UT-VT-WI-WV. Replacement |
VL 12670-NY IC |
| Used exclusively in New York by the Independent Channel Broker Dealer when replacing an individual annuity or other insurance products. Instructions for distribution of copies and materials are on the cover page of the form. Replacement. |
VL 7897 |
| Used only in Florida when replacing life insurance products including annuities funded through values in existing enforce policy with same insurer Instructions on cover page Obtain submit replacement form to expedite processing by redeeming carrier. |
VL 7744 |
| Used exclusively in California when replacing life insurance products, including annuities. Instructions are on the cover page. Obtain submit replacement form to expedite processing by redeeming carrier. |
VL 7859 |
| Used exclusively in Delaware when replacing life insurance products, including annuities. Instructions are on the cover page. Obtain submit replacement form to expedite processing by redeeming carrier. |
VL 8165 |
| Used exclusively in Idaho when replacing life insurance products, including annuities. Instructions are on the cover page. Obtain and submit replacement form to expedite processing by redeeming carrier. |
VL 27110 |
| Used exclusively in Illinois, when replacing life insurance products, including annuities. Instructions are on the cover page. Obtain and submit replacement form to expedite processing by redeeming carrier. |
VL 7814 |
| Used exclusively in Indiana when replacing life insurance products, including annuities. Instructions are on the cover page. Obtain submit replacement form to expedite processing by redeeming carrier. |
VL 14735 |
| Used exclusively in Kansas when replacing life insurance products, including annuities. Instructions are on the cover page. Obtain submit replacement form to expedite processing by redeeming carrier. |
VL 7742 |
| Used exclusively in Massachusetts when replacing life insurance products, including annuities. Instructions are on the cover page. Obtain and submit replacement form to expedite processing by redeeming carrier. |
VL 7818 |
| Used exclusively in Minnesota when replacing life insurance products, including annuities. Instructions are on the cover page. Obtain submit replacement form to expedite processing by redeeming carrier. |
VL 27289 |
| Used exclusively in Nevada when replacing life insurance products and annuities (other than individual fixed deferred annuities). Instructions on the cover page. Obtain and submit replacement form to expedite processing by redeeming carrier. |
VL 14715 |
| Used exclusively in Nevada when replacing life insurance products, including annuities. Instructions on the cover page. Submit replacement form to expedite processing by redeeming carrier. Include VL 14715-A when replacing a fixed annuity. Replacement. |
VL 12667-NY IC |
| Used exclusively in New York by Independent Channel Broker-Dealers when replacing an individual annuity or other insurance products. Instructions for distribution of copies and materials are on the cover page of the form. Replacement. PDF includes VL 19176 Authorization To Disclose Information - NY Reg 60 |
VL 12669-NY IC |
| Used exclusively in Ney York by Independent Channel Broker Dealers when replacing an individual annuity or other insurance products. Instructions for distribution of copies and materials are on the cover page of the form. Replacement. |
VL 7866 |
| Used exclusively in Oklahoma when replacing life insurance products, including annuities. Instructions are on the cover page. Obtain and submit replacement form to expedite processing by redeeming carrier. |
VL 7862 |
| Used exclusively in Pennsylvania when replacing life insurance products, including annuities. Instructions are on the cover page. Obtain submit replacement form to expedite processing by redeeming carrier. |
VL 27111 |
| Used exclusively in Tennessee when replacing life insurance products, including annuities. Instructions are on the cover page. Obtain and submit replacement form to expedite processing by redeeming carrier. |
VL 28103 |
| Used when replacing life insurance products, including annuities and with all new business in Virginia. |
VL 8096 |
| Used exclusively in Washington when replacing life insurance products, including annuities. Instructions are on the cover page. Obtain and submit replacement form to expedite processing by redeeming carrier. |
VL 7847 |
| Used exclusively in Wyoming when replacing life insurance products, including annuities. Instructions are on the cover page. Obtain and submit replacement form to expedite processing by redeeming carrier. |
VL 24844 |
| Used exclusively in Georgia when replacing life insurance products. Instructions are on the cover page. Obtain and submit replacement form to expedite processing by redeeming carrier. |
Form # | Form Name | Description |
VL 26991 | Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459. | |
VL 26991-FL | Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 for FLorida only. | |
VL 26991-NJ | Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 for New Jersey only. | |
VL 26991-NY | Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile.For use in New York only. Replaces VL 25459 NY only | |
VL 26991-VA | Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459-VA. | |
VL 26991 (406) | VALIC Fixed Annuity-406 application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 (406). | |
VL 26991-FL (406) | VALIC Fixed Annuity-406 application. For use in Florida only. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459(406) in Florida Only | |
VL 26991-NJ (406) | VALIC Fixed Annuity-406 application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459(406) in New Jersey. | |
VL 26991-NY (406) | VALIC Fixed Annuity-406 Allocation. For use in New York only. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 NY only (406) | |
VL 26991-VA (406) | VALIC Fixed Annuity-406 Allocation. For use in Virginia only. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459-VA (406). | |
VL 26470-B | Required for all Florida transactions when purchasing an annuity product and the source of the money is another annuity. Signature pages must be signed. replaces VL 22982-B | |
VC 26126 | Used to assist clients in understanding Fixed and Fixed Index Annuities in the following states AL AK AR AZ CO FL GA HI IA ID KY ME MO MT NV NJ NM NC OH OK OR RI SC UT WI and WV. Also required in AL, CO, FL, GA, IA, ME, MO, NH, OH, RI, TX, WI, and WV for Variable Annuities. Must be provided to clients at time of application for the following plan types only IRA, Roth IRA, SEP, Simple IRA and NQDA. Use appropriate guide based on client's state of residence. New Hampshire requires the NAIC buyers guide effective 4/30/2018 with 60 day implementation extension period to 6/30/2018. | |
VL 21719 | Inside Edge Mutual Fund Employee enrollment form for IRA enrollment. | |
VL 22583 | Required to establish Investment Advisory Services on a VALIC client account(s). | |
VL 14131 | Used when replacing life insurance products, including annuities and with all new business in the following states. AL-AR-AK-AZ-CO-CT-HI-IA-KY-LA-MD-ME-MO-MS-MT-NC-NE-NH-NJ-NM-OH-OR-RI-SC-SD-TX-UT-VT-WI-WV. Replacement | |
VL 28103 | Used when replacing life insurance products, including annuities and with all new business in Virginia. | |
VL 25190 | Used by the Independent Channel to transmit an additional contribution for a client and for providing the client with a receipt. Complete only as needed. | |
VL 25031 | Used exclusively by external broker-dealers to liquidate Nonqualified or Non-Insurance accounts and transfer funds to VALIC. | |
VL 23431 | Used to establish Independent Channel accounts. Must be completed and submitted with every application, VALIC transfer, rollover, exchange, except VALIC group enrollments in a variable product. Distribute form copies as noted in the legend at bottom. | |
VL 23479 | Used to authorize a reduction or termination of a salary reduction agreement for Traditional and Roth IRAs. | |
VL 22305 | Used to grant account access to Agents as named by the client or to establish a Contact Center password on the clients account. PDF only. | |
VL 259 | Required for all VALIC annuity products (fixed, variable, qualified and nonqualified ) being sold to clients who reside in CA and are 65 years of age or older if the product is being sold on the basis of its treatment under the CA Medi-Cal program. | |
VL 22059 | This disclosure form is required if the client has answered YES to being an active duty service member of the United States Armed Forces for all individual non-qualified and IRA applications. | |
VL 22415 | Used to submit beneficiary designations changes for Profile or Inside Edge Accounts only. | |
VL 23303 | Used to open an IRA-Roth IRA in the name of a Minor. Affiant agrees to indemnify VALIC, including its agents, employees, successors, and assigns from every claim, demand or suit brought against them. | |
VL 26470-A | Required for all Florida transactions when purchasing a fixed annuity product regardless of how it is funded. Signature pages must be signed. Replaces VL 22982-A | |
VC 22966 | Used in the state of Kentucky to assist clients in determining their insurance needs and the products related. Must be provided to the client. | |
SEE REPLACEMENT TAB | See Replacement Tab for access to State Replacement Forms. | |
VL 23765-IC | Used when enrolling clients in Group or Individual Annuity products in the state of New York - informing the client regarding VALICs policy of compensating its insurance producers and their role in offering insurance products. Independent Channel. | |
VL 18484 | Used exclusively by external broker-dealers to transfer-rollover in funds for ALL PLAN TYPES from a client account at another carrier to VALIC. | |
VL 22107 | Inside Edge Mutual Fund Employee Enrollment form for 401(a) enrollment. | |
VL 21555 | Inside Edge Mutual Fund Employee enrollment form for 403(b) enrollment. | |
VL 21679 | Inside Edge Mutual Fund Inidividual 403(b) Custodial Account Agreement. This document must be provided to individual at application. | |
VL 14118 | Used to authorize a salary reduction and deferral of compensation for groups offering both plans to employees. Plan must offer both plans to use this form. | |
VL 14118-ROTH | Used to authorize a salary reduction and deferral of compensation for groups offering both plans to employees with ROTH deferral available. | |
VL 3526 | Used to authorize a reduction of salary to fund a Section 403(b) plan. SRA | |
VL 3526-ROTH | Used to authorize a reduction of salary to fund a Section 403(b) plan with ROTH deferral available. | |
VL 21555-TX | Inside Edge Mutual Fund Employee enrollment form for 403(b) enrollment for use in Texas only. | |
VL 26991 | Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459. | |
VL 26991-NJ | Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 for New Jersey only. | |
VL 26991-FL | Inside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 for FLorida only | |
VL 21679 | Inside Edge Mutual Fund Inidividual 403(b) Custodial Account Agreement. This document must be provided to individual at application. | |
VL 14118 | Used to authorize a salary reduction and deferral of compensation for groups offering both plans to employees. Plan must offer both plans to use this form. | |
VL 14118-ROTH | Used to authorize a salary reduction and deferral of compensation for groups offering both plans to employees with ROTH deferral available. | |
VL 4546 | Used to authorize a deferral of salary to fund a 401(k) plan. | |
VL 4546-ROTH | Used to authorize a deferral of salary to fund a 401(k) plan with ROTH deferral available. | |
VL 21706 | Inside Edge Mutual Fund Employee Enrollment form for 457(b) enrollment. | |
VL 21680 | Inside Edge Mutual Fund Individual 457(b) Custodial Account Agreement. This document must be provided to individuals at application. | |
VL 8495 | Used for a client to defer compensation pursuant to the Employees Deferred Compensation Plan. | |
VL 8495-ROTH | Used for a client to defer compensation of a 457(b) Governmental plan pursuant to the Employees Deferred Compensation Plan. | |
VL 21706-TX | Inside Edge Mutual Fund Employee Enrollment form for 457(b)Enrollment for use in Texas only. | |
VL 21680 | Inside Edge Mutual Fund Individual 457(b) Custodial Account Agreement. This document must be provided to individuals at application. | |
VL 14118 | Used to authorize a salary reduction and deferral of compensation for groups offering both plans to employees. Plan must offer both plans to use this form. | |
VL 14118-ROTH | Used to authorize a salary reduction and deferral of compensation for groups offering both plans to employees with ROTH deferral available. | |
VL 26995 | Used by Independent Channel to enroll participants in a qualified GROUP contract. Use state specific for FL, NJ, NY and VA. PDF includes Application and Agent Access. The OA is required in all states. Replaces VL 26443. | |
VL 14945-1 | Used to submit additional beneficiary designations that exceed space allotted on VL 14945 or application forms. Must submit with VL 14945 or application form. PDF only. | |
VL 11411 | Used to provide additional fund selection space as an addendum to Application, Enrollment, Internal Combination or Rollover and Combined Enrollment or Exchange forms. PDF only. | |
VL 10330 | Used to authorize salary reductions for SIMPLE 401(k) plans. PDF only. You are responsible for distributing copies as noted in the distribution legend at the bottom of the form. | |
VL 23180 | Required by the Texas Retirement System. This form must accompany any new K-12 403(b) applications for a Series 1 contract. For Independent Channel use only. | |
VL 23181 | Required by the Texas Retirement System. This form must accompany any new K-12 403(b) applications for a Series 5 contract. For Independent Channel use only. | |
VL 26995-FL | Used by Independent Channel to enroll in a qualified GROUP contract in Florida. Use state specific for NJ, NY and VA. PDF includes Application and Agent Access. The OA is required. Replaces VL 26443-FL. | |
VL 7897 | Used only in Florida when replacing life insurance products including annuities funded through values in existing enforce policy with same insurer Instructions on cover page Obtain submit replacement form to expedite processing by redeeming carrier. | |
VL 10402 | Salary Reduction Agreement for SIMPLE IRA plans. PDF only. You are responsible for distributing copies as noted in the distribution legend at the bottom of the form. | |
VL 26995-NJ | Used by Independent Channel to enroll participants in a qualified GROUP contract in New Jersey. PDF includes Application and Agent Access. Replaces VL 26443-NJ | |
VL 26995-NY | Used exclusively by Independent Channel in New York State only to enroll participants in a qualified GROUP contract. Enrollment. PDF includes Owner Acknowledgement and Agent Access forms. Replaces VL 26443-NY | |
VL 12667-NY IC | Used exclusively in New York by Independent Channel Broker-Dealers when replacing an individual annuity or other insurance products. Instructions for distribution of copies and materials are on the cover page of the form. Replacement. PDF includes VL 19176 Authorization To Disclose Information - NY Reg 60 | |
VL 12669-NY IC | Used exclusively in Ney York by Independent Channel Broker Dealers when replacing an individual annuity or other insurance products. Instructions for distribution of copies and materials are on the cover page of the form. Replacement. | |
VL 12670-NY IC | Used exclusively in New York by the Independent Channel Broker Dealer when replacing an individual annuity or other insurance products | |
VL 26995-VA | Used by Independent Channel to enroll in a qualified GROUP contract in Virginia. PDF includes Application and Agent Access. Replaces VL 26443-VA. | |
VL 26996 | Proflex FLEXPDFA will close for new applications - sales in all states. The product will remain open for certain groups in IL and KS until a replacement product can be determined. Replaces VL 25456 | |
VL 16377 | Used to establish electronic fund transfers for IRAs, non qual tax deferred annuities (NQDAs) SEPs. |
Form # | Form Name | Description |
VL 20819 | Used to obtain information necessary to determine your eligibility for a loan under a Public Employer 403(b) plan. |
Form # | Form Name | Description |
VC 24310 | Instructions for completing VL 24176. | |
VC 24311 | Instructions for completing VL 23708. | |
VC 24312 | Instructions for completing VL 22305. | |
VC 24313 | Instructions for completing VL 22711. | |
VC 24314 | Instructions for completing VL 18484. |
Form # | Form Name | Description |
VL 26992 | Used by Independent Channel to establish New PD Groups Used with Qual and NQDA plans. Form states that the Multi-Year Enhanced Fixed Opt may not be avail in all states and has other disclosures required for an MYO. Use state specific form in MD, NY or VA. Replaces VL 26442. | |
VL 26992-NY | Used only by Indep Chan to estab New PD Groups in NY. This form is for use with Qualified and NQDA plans. Form has disclosures required for MYO. Independent Channel. Replaces VL 26442-NY. | |
VL 26992-VA | Used only by Indep Chan to estab New PD Groups in VA. This form is for use with Qualified and NQDA plans. Form has disclosures required for MYO. Independent Channel. Replaces VL 26442-VA. | |
VL 15282 | Used to establish an administrative service arrangement for 457 Deferred Compensation plans. PDF only. | |
VL 10421 | Used exclusively when the Plan Sponsor intends to -employer direct- assets from their former record keeper to VALIC. PDF only. Must provide VALIC with the most current executed plan document, adoption agreement if applicable and all amendments. | |
VL 18546 | Used to describe the forms needed to complete transactions involving External Broker Dealers selling VALIC products. | |
VL 15280-IC | Used to provide all necessary group related information (payroll contacts, payroll dates, group name address, telephone, etc). For use in the Independent Channel Only. PDF only. | |
VL 15281 | Used in ERISA covered plans to provide disclosure to the Plan Fiduciary for Agent related compensation. | |
VL 17584 | Used for new groups coming into VALIC requesting basic administration services and other optional services. Available as PDF only. | |
VL 26992-MD | Used only by Indep Chan to estab New PD Groups in MD. This form is for use with Qualified and NQDA plans. Form has disclosures required for MYO. Independent Channel. Replaces VL 26442-MD in Maryland Only. | |
VL 26992-CHOICE | Used only by Indep Chan to estab New PD Choice Groups. This form is used with Qual and NQDA plans. Form clearly states the Multi-Yr Enhanced Fixed Opt may not be avail in all states and has other discl reqd for an MYO. Use state spec app for MD, NY or VA. Replaces VL 26442 CHOICE. | |
VL 26992-MD CHOICE | Used only by Indep Chan to estab New PD Groups in MD. This form is for use with Qualified and NQDA plans. Form has disclosures required for MYO. Independent Channel. Replaces VL 26442-MD CHOICE in Maryland Only | |
VL 26992-NY CH | Used only by Indep Chan to estab New PD Choice Groups in NY. This form is for use with Qualified and NQDA plans. Form has disclosures required for MYO. Independent Channel. Replaces VL 26442-NY Choice | |
VL 26992-VA CH | Used only by Indep Chan to estab New PD Groups in VA. This form is for use with Qualified and NQDA plans. Form has disclosures required for MYO. Independent Channel. Replaces VL 26442-VA CHOICE. |
The information contained on this site is intended for financial professionals only and is not an offer to sell, recommend or solicit securities.
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Below is important information about working with Voya Financial Advisors.
Note: Some files are in PDF format. In order to open, view or print these files, you will need to have Adobe Acrobat Reader installed on your computer. This is available with a free download from the Adobe Systems website . When printing multiple-page documents, please use the two-sided option whenever possible.
Voya Financial Advisors, Inc., the broker-dealer of Voya Financial, Inc. (NYSE: VOYA), supports a wide range of clients through approximately 600 financial professionals. As a top-tier independent broker-dealer, Voya Financial Advisors is focused on helping Americans advance their retirement readiness through education, financial planning and a broad range of personalized asset accumulation, protection and distribution solutions. Voya Financial is a premier retirement, investment and insurance company serving the financial needs of over 14 million individual and institutional customers in the United States.*
Voya Financial Advisors is required to make available quarterly reports that present a general overview of its order routing practices. These reports identify the significant venues to which client orders were routed for execution during the applicable quarter. Voya Financial Advisors transmits its client orders to its clearing firm, Pershing LLC. Pershing may then route these orders to various venues for execution. To obtain a copy of this report, please visit orderroutingdisclosure.com and enter the full broker-dealer name exactly as follows: Voya Financial Advisors, Inc.
*As of 6/30/2023.
Securities and investment advisory services offered through Voya Financial Advisors, Inc. (member SIPC). See BrokerCheck for more information.
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This assignment is made and the policy is held as collateral security for any and all liabilities of the Assignors, or any of them, tothe Assignee, either ... 2000 21st Ave. NW, Minot, ND 58703; Completed forms can be emailed to: [email protected] Assignee Name Birth Date SSN/TIN Phone ( ) Assignment of life insurAnce policy As collAterAl ...
Collateral Assignment Used to assign a policy as collateral in all states. 114079. Policy Maintenance Use this form to notify Voya of a legal name change, address change or change to a trustee. 131456. Release of Assignment Allows assignee to release all rights to a policy currently assigned to them. 131538.
Administration Forms. The forms provided here are standard Administration forms, other than Claims. Any Enrollment or Application forms must be obtained through your Account Manager. Insurance products in the U.S. are provided by ReliaStar Life Insurance Company (Home and Administration Office: Minneapolis, MN) and ReliaStar Life Insurance ...
Mailing Instructions: Send form(s) to: Standard Address • PO Box 305355 • Nashville, TN 37230-5355 • Fax: 1-844-930-0370 Variable Life Service Center • PO Box 305600 • Nashville, TN 37230-5600 • Fax: 713-620-6653. 1. POLICY IDENTIFICATION. Check Here if New Address.
is to fully complete Voya's sample collateral assignment form or to make sure the written information submitted includes everything requested in the Voya form. Links to Voya Life's sample forms are included at the end of this document. For agent use only. Not for public distribution. Warning - Collateral Assignments of Modified Endowment
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3. Fill Out the Collateral Assignment Forms. Contact your life insurance company for a collateral assignment form. This form lists information about your loan, such as the amount, the repayment schedule and the lender. Once you and your lender sign this form, your insurer can officially add the lender as the collateral assignee for your policy. 4.
Individual Whole Life Required Supplemental Forms and Documents. Find the required forms and documents based on your state of residence for your Voya® Employee Benefits insurance policies. Note: These forms are in PDF format. ... Voya® Employee Benefits insurance products and services in the U.S. are provided by ReliaStar Life Insurance ...
c Split Dollar Collateral Assignment to Date The undersigned hereby releases and relinquishes all of the undersigned's rights, benefits, title and interest in the above policy. ... Website: voya.com; Completed forms can be emailed to: [email protected] ReliaStar Life Insurance Company ("ReliaStar") administers, and is solely ...
Collateral Assignment Form. Use this form to collaterally assign the policy(ies) referenced below. This form must be completed and signed by the Owner. MI Last Sufix. "Company" as referred to herein, is Massachusetts Mutual Life Insurance Company, and/or MML Bay State Life Insurance Com-pany and/or C.M. Life Insurance Company.
Voya Insurance and Annuity Company, Des Moines, IA Members of the Voya® family of companies (the "Company") Customer Service: 2000 21st Ave. NW, Minot, ND 58703 Website: voya.com; Completed forms can be emailed to: [email protected] c Collateral Assignment to Date c Split Dollar Endorsement to Date
Add forms or documentation to a claim you already started. Upload Forms . Need a form? Find it here. Track a Claim. Check the status of a claim you already submitted. ... Long Term Disability Income Insurance and/or Voya Leave Management claims: 888-305-0602, 8:00am - 6:00pm EST Monday - Friday. Find additional contact information for all other ...
Form AN-331 AMERICAN NATIONAL. RV 05-24. Collateral Assignment of Life Insurance or Annuity. Issued by American National / One Moody Plaza, Galveston, TX 77550-7947. Overnight Address. Annuity Services: Mailing Processing Center, Attn: Annuity 10427, 1949 E. Sunshine St.
As a result, any earnings in the contract lose their tax-deferred status. You will receive an IRS Form 1099-R reporting the earnings to date as taxable income for the year the contract becomes subject to assignment. You will continue to receive a Form 1099-R each year the assignment remains in force reporting any additional earnings.
Complete Assignment Of Life Insurance Policy As Collateral - Voya For in a few minutes by simply following the instructions below: Find the template you want from the library of legal forms. Select the Get form button to open it and move to editing. Fill in all the required boxes (they are yellow-colored).
This form is also used for American Pathway Elite products within Forms Bundling. VL 163. Fixed Annuity Request for a Partial 1035 Exchange. Used to request a partial withdrawal and assignment of proceeds under section code 1035a. This form is used for POWER Index and Assured Choice - available for Independent Channel. VL 102FI
The forms provided here are standard Administration forms. If any form you need is listed as "TBD" then please contact your Account Representative to order a paper supply as indicated in your Administration Manual. Any Enrollment forms and Evidence of Insurability forms must be obtained through your local Account Representative. Voya Employee ...
Locate assignment of life insurance policy as collateral voya for form and click Get Form to get started. Utilize the instruments we provide to submit your form. Highlight relevant paragraphs of your documents or blackout sensitive data with instruments that airSlate SignNow gives specifically for that function.
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Below is important information about working with Voya Financial Advisors. Note: Some files are in PDF format. In order to open, view or print these files, you will need to have Adobe Acrobat Reader installed on your computer. This is available with a free download from the Adobe Systems website.When printing multiple-page documents, please use the two-sided option whenever possible.