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PHL Variable Insurance Company (the Company 2026

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The document provides a detailed guide for clients of Nassau Life and Annuity Company regarding the process of submitting a Partial Surrender/Withdrawal Request. It outlines important considerations such as potential tax consequences, early withdrawal charges, and the need for proper signatures based on ownership type. The document includes forms for withdrawal requests, tax withholding elections, and direct deposit authorizations, emphasizing the importance of completing all sections accurately to ensure timely processing.

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Click ‘Get Form’ to open the PHL Variable Insurance Company Surrender/Withdrawal Request in the editor.
Begin by filling out Section A: Account Information. Enter your Policy/Contract Number, Insured/Annuitant Name(s), and daytime telephone number.
In Section B: Payment Method, select your preferred payment option. You can choose between a penalty-free amount or specify an amount for withdrawal.
Complete Section C: Taxes by ensuring you have filled out the Federal/State Income Tax Withholding Election form (OL4753) and attach it with your request.
If applicable, complete Section D for Tax-Sheltered Annuity requirements, checking the appropriate box based on your situation.
Finally, navigate to the Signatures and Dates section. Ensure all required signatures are provided according to ownership type and date the form appropriately.

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