Get Allianz Withdrawal Request Form

Completing the Allianz Withdrawal Request Form online is a straightforward process that allows you to request a disbursement from your fixed interest life insurance policy. This guide will provide you with a clear, step-by-step approach to ensure that each section of the form is filled out accurately and efficiently.

Follow the steps to successfully complete your withdrawal request

1. Click the ‘Get Form’ button to obtain the Allianz Withdrawal Request Form and open it for editing.
2. In Section A, enter the policyowner's printed full name and, if applicable, the joint policyowner's printed full name. Fill in the Tax ID or Social Security Number, along with daytime phone numbers and email addresses for both policy owners.
3. Proceed to Section B and select only one of the surrender options: either a partial surrender by specifying a dollar amount, or a full surrender which terminates the policy and releases Allianz from liability.
4. In Section C, if applicable, specify the dollar amount for any loans requested.
5. Complete Section D regarding tax withholding. Choose whether you want federal income tax withheld from your disbursement and indicate the percentage if withholding is elected.
6. In Section E, confirm your taxpayer identification number status and certify that the details provided are accurate to avoid any backup withholding.
7. In Section F, indicate the payee information and mailing instructions. Select whether the payment is to be made payable to the policyowner or a financial institution.
8. In Section G, ensure that both the policyowner's and joint policyowner's signatures are included, along with the date of signing. If applicable, include the signatures of any trustees or power-of-attorney.
9. Once all sections are completed and signed, you can save changes, download, print, or share the completed form as necessary.

Complete your Allianz Withdrawal Request Form online today to process your disbursement.