Follow the steps to complete the form online.

1. Click ‘Get Form’ button to retrieve the Ar00017 Tplic Tflic Asf Pdf and open it in your preferred document editor.
2. In the ‘Request Type’ section, select the appropriate change by either indicating 'Change of Representative' or 'Change of Dealer'.
3. Enter the policy or contract number in the designated field to identify the document related to your change request.
4. Fill in the date on which you are submitting the request. This helps in processing your request with a clear timeline.
5. Provide the name of the insured or annuitant. Make sure to spell the name accurately to avoid discrepancies.
6. Complete the address section with your current address, including the city, state, and zip code.
7. Sign in the designated area for the policy or contract owner. A signature is required to validate the request.
8. In the ‘Previous Dealer of Record’ section, provide the dealer's name and address to indicate the prior representation.
9. In the ‘New Dealer of Record’ section, enter the new dealer's name and address, ensuring all pertinent details are included.
10. For the ‘New Representative’ section, enter the last name, first name, and middle initial of the new representative along with their WRL Agent number.
11. End by obtaining the signature of the new agent to confirm the change request.
12. Finally, review all entered information for accuracy before saving your changes, downloading, printing, or sharing the completed form.

Complete your document submissions online with ease and confidence.