Financial Advisors: please check with your firm to determine if suitability forms are needed.
Application Packet
1Consists of instructions, application and producer’s statement. Must be completed and submitted.
Based on jurisdiction.
To find the correct packet, filter by state on our Literature page.
Application Packet
1Consists of instructions, application and producer’s statement. Must be completed and submitted(applies to all states except AL, CA, DE, FL, GU, ND, NY, SD).
PVA-APP
1Application Packet
1Consists of instructions, application and producer’s statement. Must be completed and submitted(applies to AL).
Application Packet
1Consists of instructions, application and producer’s statement. Must be completed and submitted(applies to DE, GU, ND, SD).
Application Packet
1Consists of instructions, application and producer’s statement. Must be completed and submitted(applies to CA).
Application Packet
1Consists of instructions, application and producer’s statement. Must be completed and submitted(applies to FL).
Application Packet
1Consists of instructions, application and producer’s statement. Must be completed and submitted(applies to NY).
Premium Allocation
Must be completed and submitted.
Based on jurisdiction
NAIC Replacement Form
1Must be completed and submitted with the application. Follow state replacement regulations and check for any form specific to your state. For New York, complete the NY Definition of Replacement and the NY Regulation 60 Kit.
1ANN22190
1Important Notice to Military Servicemembers and their Dependents
Must be completed and submitted for Florida residents only.
Roth IRA Acknowledgement
1Must be completed for Roth IRA purchased using new money and attached to the application.
1ANN19001
1Inherited Non-Qualified Exchange Form
Use when the proceeds are an Inherited Non-Qualified Annuity.
ANN19091
Inherited Non-Qualified Disclosure Statement
Review when the proceeds are an Inherited Non-Qualified Annuity.
ANN19090
Certificate of Deposit/Mutual Fund Redemption and Transfer Form
Use when the proceeds are part of a transfer.
Transfer/Direct Rollover Form
Use when the proceeds are a qualified transfer or rollover.
Inherited IRA Information/Transfer
Use for Inherited Individual Retirement Annuity Account (IRA) Transfers.
1ANN18752
Inherited IRA Information Disclosure Statement
Use for Inherited Individual Retirement Annuity Account (IRA) Transfers.
ANN18753
1External Roth IRA Conversion Form
Use when requesting a full or partial conversion from an eligible retirement plan held by an external financial institution to a new NYLIAC Roth IRA.
ANN18738
Internal NYLIAC Annuity Roth IRA Conversion Form
Use when requesting a full or partial conversion from an internal qualified NYLIAC annuity policy to a new NYLIAC Roth IRA annuity policy.
To view all available forms, visit the Literature search.
For Financial Professional Use Only.