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Get Annuity 1035 Exchange And Transfer/Rollover Form

L Zone 547) 5801 SW 6th Avenue Topeka, KS 66636-1001 New Business Phone # (866) 747-3421 Sammons Retirement Solutions PO Box 758546 New Business Fax # (866) 511-7038 Topeka, KS 66675-8546 This form can be used to accomplish a FULL or a PARTIAL Exchange of policies pursuant to Internal Revenue Code (IRC) Section 1035. This form can also be used for Transfers of Funds and Direct Rollovers. Complete the requested information concerning the existing policy and contract, check the appropriate boxes.

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