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Get W13123 -12A1 - Pacific Life - Annuities

Uity.com All Overnight Deliveries: 1299 Farnam Street, 6th Floor, RSD Omaha, NE 68102 Use this form to: Request a one-time withdrawal from your annuity contract. Complete Sections 1, 2, 4, 5 and 11. Request preauthorized withdrawals from your annuity contract. Complete Sections 1, 3, 4, 5 and 11. Do not use for 1035 requests. Review the prospectus before submitting a withdrawal request. If your contract is a TSA/403(b), your employer/third-party administrator must sign and complete Sec.

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