Consists 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.
NAIC Replacement Form1
Must 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.1
Important Notice to Military Servicemembers and their Dependents
Must be completed and submitted for Florida residents only.
Roth IRA Acknowledgement1
Must be completed for Roth IRA purchased using new money and attached to the application.1
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.1
Inherited IRA Information Disclosure Statement
Use for Inherited Individual Retirement Annuity Account (IRA) Transfers.
External 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.
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.
NYL Privacy Information
Must be left with client. Important Information about Procedures for Opening A New Account.
Secure Term V Contract Summary1
Must be left with client. Check for any form specific to your state.1
(Note: certain states, including AR, ID, NJ, NY and WI, require specific forms.)