For IRA and NonQualified Contracts 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Contract Number at the top of the form. This is essential for identifying your account.
3. In Section 1, provide your personal information including your name, address, and phone number. If applicable, include co-owner details.
4. Move to Section 2 and select one withdrawal option: full surrender, specific amount, or prorated withdrawal from investment options. Ensure you only select one option.
5. Complete Section 3 regarding federal income tax withholding. You can choose to withhold a percentage or opt-out if you have a W-9 on file.
6. In Section 4, choose your delivery method for the proceeds—either Electronic Fund Transfer (EFT), Federal Fund Wire, or regular mail.
7. Finally, sign and date the authorization section at the end of the form to confirm your request.

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