Get Dividend/rider Withdrawal And Dividend Option Change Request

This guide provides a comprehensive overview of how to fill out the Dividend/Rider Withdrawal And Dividend Option Change Request form effectively. Users can follow these instructions to ensure accurate completion and submission of the form online.

Follow the steps to complete the form online effortlessly.

1. Press the ‘Get Form’ button to obtain the Dividend/Rider Withdrawal And Dividend Option Change Request form and open it for editing.
2. Fill in the policy number at the top of the form, including any suffix if applicable, to identify your policy accurately.
3. Provide the policyowner’s full name, ensuring you print it clearly. Include the first name, middle initial, and last name.
4. Enter your current address and telephone number in the designated fields to ensure the company can reach you if necessary.
5. If the insured’s name differs from the policyowner, complete that section accordingly.
6. Indicate the date prepared for the request.
7. In the withdrawal section, check the appropriate boxes depending on whether you wish to withdraw all available dividends or specific amounts.
8. If necessary, specify any policy numbers to which dividends should be applied to pay premiums or loans.
9. Complete the withholding election, indicating whether you choose to have a portion withheld for income tax purposes. Provide your Social Security Number or Taxpayer Identification Number in the required area.
10. Review the Federal Income Tax Withholding Notice to understand tax implications.
11. In the Request for Change of Dividend Option section, select your preferences for future dividends.
12. Sign and date the form where indicated, ensuring you meet all signature requirements.
13. Once all sections are complete, save your changes. You can download, print, or share the form as needed.

Complete your Dividend/Rider Withdrawal And Dividend Option Change Request online today!