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Reset Form Monumental Life Insurance Company Stonebridge Life Insurance Company Transamerica Life Insurance Company Western Reserve Life Assurance Co. of Ohio Administrative Office located at 4333 Edgewood Road N.E. Cedar Rapids IA 52499-0001 Beneficiary Designation Form FAX 800-235-4782 Policy Number Insured s Name Written confirmation of this change if recorded by the Company will be mailed to the owner s address unless otherwise indicated below and initialed by the owner. Reset Form...
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Welcome to John Hancock Annuities. I'm Constance and today I'll guide you through some of the more complex sections of the Withdrawal Request Form. You may use this form to request either a full or partial withdrawal from your nonqualified or IRA Annuity contract. Making withdrawals reduces your contract value and may adversely affect your contract's guaranteed benefits. Please refer to your contract and/or the prospectus for details regarding contract withdrawals. Let's begin with Section 1. Please enter your name and the contract number exactly as it appears on your account statement. In Section 2, we offer a variety of withdrawal options that can help you minimize the impact of the withdrawal on your contract benefits. Please review each option carefully and select the option that best suits your needs. Section 3 covers tax withholding elections from you withdrawal. If you wish to opt out of federal income tax withholding, you must provide a completed IRS Form W-9 along with this Withdrawal Request Form. If you are electing federal income tax withholding, the dollar amount or percentage must equal at least 10% of the taxable portion of your withdrawal. Please carefully review section 3b on page 4 to see if state income withholding also applies to your withdrawal. In Section 4, you're required to select a payment delivery option. If this section is left blank, the withdrawal proceeds will be mailed to the owner's address on file at John Hancock. A voided check must be submitted in the contract owner's name if you are requesting the proceeds to be deposited directly into your checking account. In the Authorization section, you will need to obtain a Medallion Signature Guarantee if you answer yes to any of the following questions. Medallion Signature Guarantees are not the same as notarized signatures and must be obtained from a federally insured bank. Submit the original by mail as John Hancock is unable to accept faxed copies. Please remember that all account holders must sign and date the form. Before mailing your form, please double check that you've fulfilled all requirements for your request type, such as: You've listed your account number at the top of each page on the Withdrawal Request Form You've included a completed W-9 Form if you haven't submitted one in the past year And, if applicable, you've obtained a Medallion Signature Guarantee from a federally insured banking institution To learn more about completing forms and accessing account information, please visit our YouTube channel. Thank you for choosing John Hancock.