Get Po Box 182021, Columbus, Oh 43218-2021

Filling out the PO Box 182021 form is essential for processing account changes with Nationwide Life Insurance Company. This guide will provide you with clear, step-by-step instructions to ensure the form is completed accurately and submitted online.

Follow the steps to fill out the PO Box 182021 form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Start with the 'New Primary Producer Information' section. Here, you will need to provide your name, social security number (SSN), broker dealer or firm name, and split percentage. Ensure that the split percentage is in whole numbers only, as fractions or decimals will not be accepted.
3. If there are additional producers to be added, fill out their information in the 'Additional Producers' section. You may list up to two broker dealers or firms. For more than that, attach a separate page. Ensure to provide each producer’s name, SSN, broker dealer/firm name, and split percentage.
4. In the 'Account Change Type' section, indicate the type of account change by checking the appropriate option. Complete all required fields based on your selection.
5. Provide your own information in the 'Owner Information' section, including your name and SSN. If there is a joint owner, fill in their name and SSN as well.
6. If the account is for Variable Annuities or Variable Life Policies, make a selection regarding Exchange Authorization in the respective section.
7. If applicable, provide information about any Third Party Manager or Investment Advisor in the subsequent section, indicating whether to keep or remove them from the contract.
8. Sign the form in the 'Signature(s)' section. Both the primary owner and any joint owners must print their names, sign, and date the form. Ensure that all signatures are completed as required.
9. Complete the 'Firm or Plan Authorization and Acknowledgments' section, which may require additional signatures from authorized firm representatives.
10. Once all sections are filled out, review the form to ensure accuracy and completeness. Save your changes and proceed to download, print, or share the completed form as needed.

Ensure to complete the PO Box 182021 form online today for your account changes.