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How do I fill this out?

To fill out this form, begin by entering your policy number and owner information. Next, select whether you want to request a partial withdrawal or a full surrender. Finally, provide the relevant tax withholding information and submit the completed form.

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How to fill out the Annuities Request for Disbursement Form?

  1. 1

    Enter your policy number and owner's details.

  2. 2

    Choose between partial withdrawal or full surrender.

  3. 3

    Fill in tax withholding elections.

  4. 4

    Provide banking information for EFT if applicable.

  5. 5

    Sign and submit the form as instructed.

Who needs the Annuities Request for Disbursement Form?

  1. 1

    Policyholders requesting funds from their annuity.

  2. 2

    Financial advisors needing to manage clients' disbursements.

  3. 3

    Accountants preparing tax documents for clients.

  4. 4

    Joint owners of annuities who need to authorize withdrawals.

  5. 5

    Estate executors managing disbursements of an inherited annuity.

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What are the instructions for submitting this form?

Submit the filled-out form to Fidelity & Guaranty Life Insurance Company through mail or fax. The physical address for mailing is P.O. Box 81497, Lincoln, NE 68501-1497, and the fax number is 402-328-2266. Ensure all fields are completed accurately for swift processing.

What are the important dates for this form in 2024 and 2025?

Key dates for this form in 2024 include submission deadlines for tax forms on April 15, 2024. It's crucial to have your disbursement requests in before these dates to ensure timely processing. In 2025, similar deadlines will apply.

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What is the purpose of this form?

The Annuities Request for Disbursement Form is designed for policyholders who wish to withdraw funds from their annuity accounts with Fidelity & Guaranty Life Insurance Company. This form facilitates both partial withdrawals and full surrenders, ensuring that the process adheres to regulatory and company policies. By completing this form accurately, policyholders can effectively manage their disbursement requests while complying with necessary tax withholding regulations.

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Tell me about this form and its components and fields line-by-line.

This form contains various fields necessary for completing the disbursement request process.
fields
  • 1. Policy Number: The unique identifier for the annuity policy.
  • 2. Owner Information: Details about the primary owner of the policy.
  • 3. Withdrawal Selection: Indicates whether a partial or full withdrawal is requested.
  • 4. Tax Withholding Elections: Options for federal and state tax withholding.
  • 5. Banking Information: Details required for electronic fund transfers.

What happens if I fail to submit this form?

If the form is not submitted, your request for disbursement will remain unprocessed, delaying access to your funds. Additionally, you may miss important tax deadlines associated with your withdrawal. It's essential to ensure the form is filled out correctly and submitted on time.

  • Delayed Processing: Failure to submit will result in delays in receiving funds.
  • Tax Implications: Missed deadlines may lead to unexpected tax consequences.
  • Joint Owner Issues: Without proper submission, joint ownership issues may arise.

How do I know when to use this form?

You should use this form when you intend to request a withdrawal or surrender of your annuity. It is essential for both partial and full disbursements. Completing this form ensures that your request is processed correctly and in a timely manner.
fields
  • 1. Requesting Partial Withdrawal: Use when you need to withdraw a portion of your funds.
  • 2. Requesting Full Surrender: Utilize this form for withdrawing all funds from the annuity.
  • 3. Tax Elections for Disbursements: Necessary for indicating how much tax should be withheld.

Frequently Asked Question

How do I request a disbursement using this form?

Fill in your policy number and select the type of disbursement you need. Complete the required information and submit.

Can I edit the PDF after downloading?

Yes, you can edit the PDF on PrintFriendly before downloading it.

What tax information do I need to provide?

You will need to complete the tax withholding elections section of the form.

Is there a minimum withdrawal amount?

Yes, the minimum amount for a partial withdrawal is $500.

How will my withdrawal be processed?

Withdrawals will be processed as checks or electronic funds transfers based on your selection.

How long does it take to process my request?

Generally, it takes about 10 business days to process your request.

Can I share this form with my financial advisor?

Yes, you can easily share the PDF with anyone who needs it.

What do I do if I make a mistake on the form?

You can edit the form again on PrintFriendly and correct any mistakes.

Do I need my spouse's consent for this form?

Yes, if you reside in a community property state, your spouse must sign the form.

What happens if I do not submit this form?

If you fail to submit the form, your disbursement request will not be processed.

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Annuities Request for Disbursement Form

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