Get Nationwide Agent Of Record Change Form

This guide provides clear instructions on how to complete the Nationwide Agent Of Record Change Form online. By following these steps, users can ensure a smooth and accurate submission process.

Follow the steps to efficiently fill out the form online

1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. In Section A, check the type of account change that applies, and provide the required Policy or Contract number as well as the Plan or Case number or name.
3. In Section B, enter the information for the agent(s) being placed on the policy. Fill in the names of up to four agents and their Split % as whole numbers. Include the required Social Security Number for each primary agent.
4. If applicable, complete Section C regarding Exchange Authorization. Indicate whether you elect to grant your new Agent fund to fund exchange authorization by selecting the corresponding option.
5. For Section D, provide relevant Investment Advisor Information if your contract involves variable annuities or a Third Party Manager.
6. In Section E, sign and date the form. Ensure that the required signatures are provided based on the type of transfer and include all pertinent contact information as necessary.
7. Once all sections are complete, you can save any changes made, download the form, print it, or share it as needed.

Complete your document online today for a seamless process.