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Annuity surrenderwithdrawal request 2026

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The document is an annuity surrender/withdrawal request form from Horace Mann Life Insurance Company. It outlines the procedures for requesting withdrawals or rollovers from annuity contracts, including necessary information, potential tax implications, and options for distribution methods. The form emphasizes the importance of accurate completion to avoid delays and includes sections on tax withholding elections, delivery methods for proceeds, and required signatures. Additionally, it provides special tax notices regarding rollovers and distributions from both traditional and designated Roth accounts.

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Click ‘Get Form’ to open the Annuity surrender/withdrawal request in the editor.
Begin by filling out Section C, 'Your information.' Enter your name, contract number, address, phone numbers, and last four digits of your SSN.
In Section D, 'Your requested amount,' select whether you want to surrender your contract or make a net or gross withdrawal. Specify the amount and method of withdrawal.
Complete Section E by indicating the reason for your request. Choose from options like cash value on account or disability.
In Section F, make your tax withholding elections. Decide if you want federal and state income tax withheld from your payment.
Fill out Section G with your preferred delivery method for the proceeds—either check or direct deposit. Provide necessary bank details if applicable.
Finally, sign in Section H to certify that you have read all notices and understand the implications of this transaction.

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