List of currently available ALLIANZ LIFE forms on Laser App, 222 Qualified Plan Acknowledgement Form and ERISA Disclosure - 222-ERPOS, 360 Qualified Plan Acknowledgement Form and ERISA Disclosure - 360-ERPOS, ABC Lifetime Withdrawal Election Form - S2301, ABC Qualified Plan Acknowledgement Form and ERISA Disclosure - ABC-ERPOS, Allianz 222 Annuity Disclosure - 222-DISC-NJ [NJ], Allianz 360 Annuity Disclosure - 360-DISC-NJ [NJ], Allianz ABC Annuity Disclosure - ABC-DISC-NJ [NJ], Allianz Core Income 7 Annuity Disclosure - CI7-DISC-NJ [NJ], Allianz Endurance Plus Annuity Disclosure - DISC50915-NJ03 [NJ], Allianz Index Advantage ADV Disclosure - IXA-DISC-ADV [PA], Allianz Index Advantage ADV Disclosure - IXA-DISC-MN-ADV [MN], Allianz Index Advantage Disclosure - INY-DISC [NY], Allianz Index Advantage Disclosure - IXA-DISC-MN [MN], Allianz Index Advantage Disclosure - IXA-DISC-PA [PA], Allianz Index Advantage Income Disclosure - IAI-DISC, Allianz Index Advantage Income Disclosure - IAI-DISC-MN [MN], Allianz Index Advantage Income Disclosure - IAI-DISC-PA [PA], Allianz Index Advantage NF Disclosure - IXA-DISC-MN-NF [MN], Allianz Index Advantage NF Disclosure - IXA-DISC-NF [MA-PA-VA], Allianz MasterDex X Annuity Disclosure - DISC52575-NJ01 [NJ], Allianz PRIME Plus Benefit Election Form for Reset of Annual Increase - USA-1282 [Generic], Allianz PRIME Plus Benefit Selection - USA-1279 [Generic], Allianz Request for Tax Withholding Change - SFAL0010, Allianz Request for Tax Withholding Change - SFAL0010-NY [NY], Allianz Retirement Advantage Lifetime Income Payment Selection Form - REA-014 [Generic], Allianz Retirement Advantage Lifetime Income Payment Selection Form - REA-014-NJ [NJ], Allianz Retirement Advantage NY Lifetime Income Payment Selection Form - REA-014-NY [NY], Allianz Retirement Advantage NY Variable Annuity Dollar Cost Averaging Instruction - REA-012-NY [NY], Allianz Retirement Advantage Variable Annuity Dollar Cost Averaging (DCA) Instructions - REA-012, Allianz Retirement Advantage Variable Annuity Flexible Rebalancing Instructions - REA-013, Allianz Retirement Advantage Variable Annuity Flexible Rebalancing Instructions - REA-013-NY [NY], Allianz Retirement Foundation ADV Annuity Application - ICC17-RFA-APP [Generic], Allianz Retirement Foundation ADV Annuity Application - RFA-APP [DC-DE-ND-SD], Allianz Retirement Foundation ADV Annuity Application - RFA-APP-CA [CA], Allianz Retirement Foundation ADV Annuity Application - RFA-APP-CT [CT], Allianz Retirement Foundation ADV Annuity Application - RFA-APP-FL [FL], Allianz Retirement Foundation ADV Annuity Application - RFA-APP-LA [LA], Allianz Retirement Foundation ADV Annuity Application - RFA-APP-NF, Allianz Retirement Pro - Income Advantage Payment Selection/Change Form - PLI-105-NY [NY], Allianz Retirement Pro NY Variable Annuity Withdrawal Request - PLI-110-NY [NY], Allianz RFA Annuity Disclosure - RFA-DISC-01-NJ [NJ], Allianz Vision - Add Income Protector to Existing Contract - USA-1453 [Generic], Allianz Vision - Income Focus Payment Selection/Change Form - PLI-123-NY [NY], Allianz Vision - Remove Form - USA-1419 [Generic], Allianz Vision - Remove Form - VNY-047 [NY], Allianz Vision and Allianz Collections - Income Focus Payment Selection/Change - USA-1729-NJ [NJ], Allianz Vision and Allianz Collections - Income Focus Payment Selection/Change Form - USA-1729, Allocation Change Form - Allianz Valuemark II - PLI-302-NY [NY], Allocation Change Form - Allianz Valuemark II - USA-1700 [Generic], Allocation Change Form - Alterity/ Rewards - USA-1649, Allocation Change Form - Custom Income - USA-1328 [Generic], Allocation Change Form - High Five NY/Advantage/Opportunity and Charter II NY - PLI-088 [NY], Allocation Change Form - High Five/High Five L/High Five Bonus - USA-1329 [Generic], Allocation Change Form - Retirement Pro - PLI-102-NY [NY], Allocation Change Form - Vision and Connections - Income Focus - USA-1728, Allocation Change Form - Vision and Connections - Income Protector (old) - USA-1451 [Generic], Allocation Change Form - Vision and Connections - Income Protector - USA-1727, Allocation Change Form - Vision and Connections - Investment Protector (old) - USA-1452 [Generic], Allocation Change Form - Vision and Connections - Investment Protector - USA-1780, Allocation Change Form - Vision and Connections - LPB and TDR - USA-1330 [Generic], Allocation Change Form - Vision and Connections - No Additional Benefit - USA-1781, Allocation Change Form - Vision NY - Income Focus - PLI-122-NY [NY], Allocation Change Form - Vision NY - Income Protector (old) - VNY-052 [NY], Allocation Change Form - Vision NY - Income Protector - VNY-162 [NY], Allocation Change Form - Vision NY - Investment Protector (old) - VNY-053 [NY], Allocation Change Form - Vision NY - Investment Protector - VNY-177 [NY], Allocation Change Form - Vision NY - LPB and TDR - PLI-089-NY [NY], Allocation Change Form - Vision NY - No Additional Benefit - VNY-178 [NY], Allocation Change Request Form - S2213-10, Allocation Change Request Form - S2213-12, Allocation Change Request Form - S2213-13, Allocation Change Request Form - S2213-14, Allocation Change Request Form - S2213-15, Allocation Change Request Form - S2213-16, Allocation Change Request Form - S2213-17, Allocation Change Request Form - S2213-18, Allocation Change Request Form - S2213-19, Allocation Change Request Form - S2213-20, Allocation Change Request Form - S2213-SR-20, Allocation Change Request Form - S2213-SR-9, Allocation Change Request Form - S2305 [IA], Allocation Change Request Form - S2306 [NH], Annuitant Change Request - SFAL0018-LA [LA], Annuitization Quote Request - PLI-119-NY [NY], Annuitizing Annuity and Life Contracts - PLI-115-NY [NY], Annuitizing Annuity and Life Contracts Packet - PLI-107-NY [NY], Annuitizing Annuity and Life Contracts Packet - USA-487 [Generic], Annuitizing Annuity Contracts and Life Insurance Policies - SFAL-0004, Annuitizing Annuity Contracts and Life Insurance Policies - SFAL-0004-NY [NY], Annuity Application - Bonus MasterDex - AP-50626-NY [NY], Annuity Application - ICC18-FIA-APP-ALT [IA], Annuity Application - ICC18-FIA-APP-MT [MT], Annuity Application - MasterDex - AP-50614-NY [NY], Authorization to Release Information - S2194, Authorization to Transfer Assets from a Financial Institution (Fixed) - S2255, Authorization to Transfer Assets from a Financial Institution (Fixed) - S2255-NY [NY], Authorization to Transfer Assets from a Financial Institution (Variable) - S2255, Authorization to Transfer Assets from a Financial Institution (Variable) - S2255-NY [NY], Automatic Investment Plan (AIP) Form - PLI-032-NY [NY], Automatic Investment Plan (AIP) Form - USA-1278 [Generic], Automatic Payment Plan - EFT Authrorization - NBAL0042, Automatic Payment Plan - EFT Authrorization - NBAL0042-NY [NY], Beneficial/Inherited IRA RMD Election Form - NBAL0036, Beneficial/Inherited IRA RMD Election Form - NBAL0036-NY, Beneficiary Designation Request - SFAL0012, Beneficiary Designation Request - SFAL0012-NY [NY], Beneficiary Stretch Distribution - PLI-098-NY [NY], Beneficiary Stretch Distribution - USA-1265N [Generic], Benefit Deposited with Interest Option Claim Form - S2070-01, Buyer's Guide for Fixed Deferred Annuities - ANB-LE (1999), Buyer's Guide for Fixed Deferred Annuities - ANB-LE (2013) [Generic], Buyers Guide for Deferred Annuities (Variable) - ANB-LA [GA], Buyers Guide for Deferred Annuities - ANB-LV (2013) [AL-CO-FL-GA-IA-ME-MO-NH-OH-RI-TX-WV-WI], Buyers Guide to Fixed Indexed Annuities - NB4023 [VT], California Elder Disclosure - NBAL0053 [CA], California Senior (age 60 or older) Free Look - USA-699 [CA], Certification for 72(t) and 72(q) Withdrawals - USA-388N, Certification for 72(t) and 72(q) Withdrawals - USA-388NY [NY], Certification of Attorney-in-Fact Form - NBAL0052, Certification of Attorney-in-Fact Form - NBAL0052-NY [NY], CI7 Qualified Plan Acknowledgement Form and ERISA Disclosure - CI7-ERPOS, Civil Union and Equality Act of 2011 Notice - NB6079 [DE], Client Contract Update Request - USA-383 [Generic], Client Contract Update Request - USA-383NY [NY], Command Provider Annuity Application - AIMS-CP [Generic], Command Provider Annuity Application - AIMS-CP-FL [FL], Command Provider Annuity Application - AIMS-CP-MA [MA], Command Provider Annuity Application - AIMS-CP-OR [OR], Command Provider Annuity Application - AIMS-CP-TX [TX], Commission Information Quick Guide - CIQG04, Connections Qualified Acknowledgement Form and ERISA Disclosure - CNT-ERPOS, Continuing Annuity Option Settlement Claim Form - S2069-01, Continuing Annuity Option Settlement Claim Form - S2069-NY [NY], Custom Income Flexible Rebalancing - USA-059 [Generic], Custom Income Variable Annuity Income Option Selection - CST-015 [Generic], Customer Authorization of Transfer by Third Party - USA-1300 [Generic], Customer Authorization of Transfer by Third Party - USA-1300-NY [NY], Customer Authorization of Transfer by Third Party Money Manager - USA-1301 [Generic], Customer Authorization of Transfer by Third Party Money Manager - USA-1301-NY [NY], Disclosure Form/Preliminary Contract Summary - 222-SOU-AZ [AZ], Disclosure Form/Preliminary Contract Summary - ABC-SOU-AZ [AZ], Disclosure Form/Preliminary Contract Summary - Allianz 360 - 360-SOU-AZ [AZ], Disclosure Form/Preliminary Contract Summary - Allianz Core Income 7 - CI7-SOU-AZ [AZ], Disclosure to California Residents (age 65 or older) - USA-090 [CA], Disclosure to Minnesota Resdients - Index Advantage ADV - IXA-DISC-MN2-ADV [MN], Disclosure to Minnesota Residents - Index Advantage ADV - IXA-DISC-MN2-NF [MN], Disclosure to Minnesota Residents - Index Advantage Income - IAI-DISC-MN2, Dollar Cost Averaging (DCA) - PLI-030NY [NY], Dollar Cost Averaging (DCA) - Retirement Pro - PLI-103-NY [NY], Dollar Cost Averaging (DCA) - USA-354 [Generic], Dollar Cost Averaging - Alterity/ Rewards - USA-1650, Enhanced Withdrawal Benefit (EWB) Election Form - S2291, Entity Customer Information Form - NBAL0055 [Generic], Entity Customer Information Form - NBAL0055-NY [NY], ERISA Section 408(b)(2) Disclosure - DISC52575-ERPOS, ERISA Section 408(b)(2) Disclosure - DISC54370-ERPOS, ERISA Section 408(b)(2) Disclosure - DISC59951-02-ERPOS, ERISA Section 408(b)(2) Disclosure - DISC95374-ERPOS, ERISA Section 408(B)(2)Disclosure - DISC95376-ERPOS, Five Year Deferral Service Form - S2241 [Generic], Five Year Deferral Service Form - S2241-NY [NY], Flexible Rebalancing - Alterity/ Rewards - USA-1651, Flexible Rebalancing - Retirement Pro - PLI-104-NY [NY], Income Maximizer Rider Disclosure Form - SOU95331-03-AZ [AZ], Income Maximizer Rider Statement of Understanding - SOU95331-03 [Generic], Income Maximizer Rider Statement of Understanding - SOU95331-03-CT [CT], Income Maximizer Rider Statement of Understanding - SOU95331-03-FL [FL], Income Maximizer Rider Statement of Understanding - SOU95331-03-OK01 [OK], Income Maximizer Rider Statement of Understanding - SOU95331-03-WI [WI], Income Maximizer Rider Statement of Understanding - SOU95331-GMV-03 [DE-IL-OH-TX], Income Maximizer Rider Statement of Understanding - SOU95331-GMV-03-NC [NC], Income Maximizer Rider Statement of Understanding - SOU95331-GMV-03-NJ [NJ], Income Maximizer Rider Statement of Understanding - SOU95331-ICC-04 [MN-MO-MS-UT], Income Maximizer Rider Statement of Understanding - SOU95331-ICC-04-OR [OR], Income Maximizer Rider Statement of Understanding - SOU95331-ICC-04-PA [PA], Income Maximizer Rider Statement of Understanding - SOU95331-ICC-NFWR-04 [AK-WA], Income Maximizer Rider Statement of Understanding - SOU95331-MSRP-03-CA [CA], Income Maximizer Rider Statement of Understanding - SOU95331-NFWR-03 [MA-SD], Income Payment Selection/Change Form - IAI-153 [Generic], Income Plus / Simple Income Benefit Election Form for Contract - S2212-1, InCommandDex Annuity Request for Annuity Settlement Options - S2160, Index Advantage ADV Qualified Plan Acknowledgement Form and ERISA Disclosure - IXA-ERPOS-ADV, Index Advantage ADV Variable Annuity Application Tipsheet - IXA-001-ADV, Index Advantage Income Qualified Acknowledgement Form and ERISA Disclosure - IAI-ERPOS, Index Advantage Income Variable Annuity Application - IAI-APP-03 [CA-DE-ND-SD], Index Advantage Income Variable Annuity Application - IAI-APP-03-FL [FL], Index Advantage Income Variable Annuity Application - IAI-APP-03-LA [LA], Index Advantage Income Variable Annuity Application - IAI-APP-03-NC [NC], Index Advantage Income Variable Annuity Application - ICC20-IAI-APP-03 [Generic], Index Advantage Income Variable Annuity Application - ICC20-IAI-APP-03-NJ [NJ], Index Advantage Income Variable Annuity Application - ICC21-IAI-APP-03-MN [MN], Index Advantage Income Variable Annuity Application Tipsheet - IAI-001, Index Advantage New York Qualified Plan Acknowledgement Form and ERISA Disclosure - INY-ERPOS [NY], Index Advantage New York Regulation 60 Forms Package - INY-055 [NY], Index Advantage NF Qualified Plan Acknowledgement Form and ERISA Disclosure - IXA-ERPOS-NF, Index Advantage NF Variable Annuity Application Tipsheet - IXA-001-NF, Index Advantage Qualified Plan Acknowledgement Form and ERISA Disclosure - IXA-ERPOS, Index Advantage Variable ADV Annuity Application - ICC20-IXA-APP-03-ADV [Generic], Index Advantage Variable ADV Annuity Application - ICC20-IXA-APP-03-NJ-ADV [NJ], Index Advantage Variable ADV Annuity Application - ICC21-IXA-APP-03-MN-ADV [MN], Index Advantage Variable ADV Annuity Application - IXA-APP-03-ADV [CA-DE-ND-SD], Index Advantage Variable ADV Annuity Application - IXA-APP-03-FL-ADV [FL], Index Advantage Variable ADV Annuity Application - IXA-APP-03-LA-ADV [LA], Index Advantage Variable ADV Annuity Application - IXA-APP-03-NC-ADV [NC], Index Advantage Variable ADV Annuity Application - IXA-APP-MOWA-01-ADV [MO-WA], Index Advantage Variable ADV Annuity Application - IXA-APP-MT-ADV [MT], Index Advantage Variable Annuity Application - F40538-02-NY [NY], Index Advantage Variable Annuity Application - ICC20-IXA-APP-03 [Generic], Index Advantage Variable Annuity Application - ICC20-IXA-APP-03 [HI], Index Advantage Variable Annuity Application - ICC20-IXA-APP-03-NJ [NJ], Index Advantage Variable Annuity Application - ICC21-IXA-APP-03-MN [MN], Index Advantage Variable Annuity Application - IXA-APP-03 [CA-DE-ND-SD], Index Advantage Variable Annuity Application - IXA-APP-03-FL [FL], Index Advantage Variable Annuity Application - IXA-APP-03-LA [LA], Index Advantage Variable Annuity Application - IXA-APP-03-NC [NC], Index Advantage Variable Annuity Application - IXA-APP-MOWA-01 [MO-WA], Index Advantage Variable Annuity Application Tipsheet - INY-016 [NY], Index Advantage Variable Annuity Application Tipsheet - IXA-001, Index Advantage Variable NF Annuity Application - ICC17-IXA-APP-NF [MT], Index Advantage Variable NF Annuity Application - ICC20-IXA-APP-03-NF [Generic], Index Advantage Variable NF Annuity Application - ICC20-IXA-APP-03-NJ-NF [NJ], Index Advantage Variable NF Annuity Application - ICC21-IXA-APP-03-MN-NF [MN], Index Advantage Variable NF Annuity Application - IXA-APP-03-FL-NF [FL], Index Advantage Variable NF Annuity Application - IXA-APP-03-LA-NF [LA], Index Advantage Variable NF Annuity Application - IXA-APP-03-NC-NF [NC], Index Advantage Variable NF Annuity Application - IXA-APP-03-NF [CA-DE-ND-SD], Index Advantage Variable NF Annuity Application - IXA-APP-MOWA-01-NF [MO-WA], Index Anniversary Rebalance Form - IAI-022 [Generic], Index Anniversary Rebalancing and Transfers between the Allocation Options - INY-019 [NY], Index Anniversary Rebalancing and Transfers between the Allocation Options - IXA-022, Individual Customer Information Form - NBAL0054 [Generic], Individual Customer Information Form - NBAL0054-NY [NY], Interested Party Statement Request - USA-851 [Generic], Interested Party Statement Request - USA-851-NY [NY], Investment Advisor Representative Client Authorization - NBAL0043, Investment Advisor Representative Client Authorization - NBAL0043-NY [NY], Investment Advisor Representative Information - NBAL0044, Investment Advisor Representative Information - NBAL0044-NY [NY], Investment Allocation Guide - VNY-142 [NY], Investment Allocation Guide - VSN-145 [Generic], IRA Excess Contribution Removal Form - S2235, IRA Excess Contribution Removal Form - USA-1506 [Generic], IRA Excess Contribution Removal Form - USA-1506-NY [NY], Lifetime Withdrawal Benefit/Income Maximizer Election Form - S2212-PREFD, Military Sales Forms Packet - USA-1461 [Generic], Military Sales Forms Packet - USA-1461 [NY], Non-Individual Ownership Form - NB6059-NY [NY], Non-Individual Ownership Form - PLI-086 [NY], Non-Individual Ownership Form - USA-1327 [Generic], Nonresident Sales Form - Information Page - NBAL6078, Nonresident Sales Form - Information Page - NBAL6078-NY [NY], Notice Regarding Medi-Cal Eligibility (Fixed) - NB5003-CA [CA], Notice Regarding Medi-Cal Eligibility (Variable) - NB5003-CA [CA], Notice to Connecticut Financial Professionals - IXA-DISC-CT2 [CT], Partial Settlement Options Request for Contract - S2247, Partial Settlement Options Request for Contract - S2247-NY [NY], Performance Lock Request Form - INY-106 [NY], Policy Payment Electronic Funds Transfer (EFT) - Clients - S2071, Policy Payment Electronic Funds Transfer (EFT) - Clients - S2071-NY [NY], PRIME - Guaranteed Partial Withdrawal Benefit (GPWB) Payment Election - 403(b) - PLI-100-NY [NY, PRIME - Guaranteed Partial Withdrawal Benefit (GPWB) Payment Election - 403(b) - USA-1567 [Generic], PRIME - Guaranteed Partial Withdrawal Benefit (GPWB) Payment Election - USA-1519 [Generic], PRIME Plus (GPWB) Payment Election - USA-1520, Producer Change Request - S2249 [Generic], Product Suitability Form - NB3051 [Generic], Product Suitability Form - NB3051-CA [CA], Product Suitability Form - NB3051-FL-02 [FL], Product Suitability Form - NB3051-MA [MA], Product Suitability Form - NB3051-MT [MT], Product Suitability Form - NB3051-NJ [NJ], Qualified Disbursement Request - S2085-NY [NY], Qualified Plan Acknowledgement - USA-337-NY [NY], Qualified Plan Acknowledgement and Custodial IRA Agreement - S2236, Qualified Plan Acknowledgement and Custodial IRA Agreement - S2236-NY [NY], Quick Tips for Completing the NY Reg 60 Disclosure Statement - PLI-120-NY [NY], Reg 60 Part D Tipsheet - Index Advantage NY - PLI-125-NY-IXA [NY], Reg 60 Part D Tipsheet - Retirement Pro NY - PLI-125-NY-RET [NY], Registered Representative Appointment Request - USA-678A [Generic], Registered Representative Appointment Request - USA-678NY [NY], Regulation 60 Disclosure Statement - NB2273-NY [NY], Regulation 60 Sales Material Checklist - NB2274-NY [NY], Regulation 60 Sales Material Checklist - PLI-081-NY [NY], Regulation 60 Six-Step Process - NB2278-NY [NY], Regulation 60 VA Disclosure Statement - PLI-092-NY [NY], Regulation 60 VA Replacement - PLI-090-NY [NY], Replacement Comparison Worksheet (Fixed) - NBAL0023-AR [AR], Replacement Comparison Worksheet (Variable) - NBAL0023-AR [AR], Replacement Comparison Worksheet - NB6023, Replacement Comparison Worksheet Tip Sheet (Fixed) - NBAL0022-AR [AR], Replacement Comparison Worksheet Tip Sheet (Variable) - NBAL0022-AR [AR], Replacement List (Fixed) - NBAL0028-IL [IL], Replacement Notice (Fixed) - NBAL0026-IL [IL], Replacement Notice (Fixed) - NBAL0037-KS [KS], Replacement Notice (Fixed) - NBAL0038-KS [KS], Replacement Of Life Insurance Or Annuities (Fixed) - NBAL0021-MO [MO], Replacement Of Life Insurance Or Annuities (Variable) - NBAL0021-MO [MO], Replacement Packet (Fixed) - NBAL0001-01 [LA-VA], Replacement Packet (Fixed) - NBAL0001-MO [MO], Replacement Packet (Fixed) - NBAL0002-CA [CA], Replacement Packet (Fixed) - NBAL0003-DE [DE], Replacement Packet (Fixed) - NBAL0004-FL [FL], Replacement Packet (Fixed) - NBAL0005-GA [GA], Replacement Packet (Fixed) - NBAL0006-ID [ID], Replacement Packet (Fixed) - NBAL0007-IL [IL], Replacement Packet (Fixed) - NBAL0008-IN [IN], Replacement Packet (Fixed) - NBAL0009-MA [MA], Replacement Packet (Fixed) - NBAL0010-MI [MI], Replacement Packet (Fixed) - NBAL0011-MN [MN], Replacement Packet (Fixed) - NBAL0013-ANN-NV [NV], Replacement Packet (Fixed) - NBAL0014-OK [OK], Replacement Packet (Fixed) - NBAL0015-PA [PA], Replacement Packet (Fixed) - NBAL0017-TN [TN], Replacement Packet (Fixed) - NBAL0018-WA [WA], Replacement Packet (Fixed) - NBAL0019-WY [WY], Replacement Packet (Fixed) - NBAL0020-AR [AR], Replacement Packet (Variable) - NBAL0001-01 [LA-VA], Replacement Packet (Variable) - NBAL0001-MO [MO], Replacement Packet (Variable) - NBAL0002-CA [CA], Replacement Packet (Variable) - NBAL0003-DE [DE], Replacement Packet (Variable) - NBAL0004-FL [FL], Replacement Packet (Variable) - NBAL0005-GA [GA], Replacement Packet (Variable) - NBAL0006-ID [ID], Replacement Packet (Variable) - NBAL0007-IL [IL], Replacement Packet (Variable) - NBAL0008-IN [IN], Replacement Packet (Variable) - NBAL0009-MA [MA], Replacement Packet (Variable) - NBAL0010-MI [MI], Replacement Packet (Variable) - NBAL0011-MN [MN], Replacement Packet (Variable) - NBAL0013-ANN-NV [NV], Replacement Packet (Variable) - NBAL0014-OK [OK], Replacement Packet (Variable) - NBAL0015-PA [PA], Replacement Packet (Variable) - NBAL0017-TN [TN], Replacement Packet (Variable) - NBAL0018-WA [WA], Replacement Packet (Variable) - NBAL0019-WY [WY], Replacement Packet (Variable) - NBAL0020-AR [AR], Replacement Packet - NAIC/multi-state (Fixed) - NBAL0001, Replacement Packet - NAIC/Multi-state (Variable) - NBAL0001, Representative/Agent Change Form - PLI-037NY [NY], Representative/Agent Change Form - USA-374 [Generic], Request for Allocation Change Form - S2068, Request for Allocation Change Form - S2266, Request for Allocation Change Form - S2266-1, Request for Allocation Change Form - S2266-2, Request for Allocation Change Form - S2267-1 [CA-HI-ID-OK-OR-RI], Request for Allocation Change Form - S2267-2, Request for Allocation Change Form - S2268, Request for Allocation Change Form - S2268-1, Request for Allocation Change Form - S2269, Request for Allocation Change Form - S2269-1, Request for Allocation Change Form - S2269-2, Request for Allocation Change Form - S2269-3, Request for Allocation Change Form - S2269-SR, Request for Allocation Change Form - S2269-SR-1, Request for Allocation Change Form - S2269-SR-2, Request for Allocation Percentage Chage (Optionsa) - MasterDex X - S2213-SR-5, Request for Allocation Percentage Change - BonusDe Elite, FlexDex MC Elite - S2075, Request for IRA Contribution Recharacterization - SFAL-0006, Request for IRA Contribution Recharacterization - SFAL-0006-NY, Request for IRA Recharacterization - S2187, Request for IRA Recharacterization - USA-1504 [Generic], Request for IRA Recharacterization - USA-1504-NY [NY], Request for Roth IRA Conversion - SFAL-0008 [Generic], Request for Tax Reporting of Premature Distribution Due to Disability - USA-1299 [Generic], Request for Tax Reporting of Premature Distribution Due to Disability - USA-1299-NY [NY], Request to Change Contract Information - S2004 [Generic], Request to Change Contract Information - S2004-NY [NY], Required Minimum Distribution (RMD) - Retirement Pro - PLI-112-NY [NY], Required Minimum Distribution (RMD) - USA-382N [Generic], Required Minimum Distribution (RMD) - USA-382NY [NY], Required Minimum Distribution Election Form - S2230 [Generic], Required Minimum Distribution Election Form - S2230-NY [NY], Retirement Pro - Certification for IRC Sec 72(t) or 72(q) Withdrawals - PLI-111-NY [NY], Retirement Pro VA 72(t) or 72(q) Withdrawals - USA-1598, Retirement Pro VA Allocation Change Form - USA-1574, Retirement Pro VA Dollar Cost Averaging (DCA) - USA-1575, Retirement Pro VA Flexible Rebalancing - USA-1576, Retirement Pro VA Income Advantage Payment Selection/Change Form - USA-1577, Retirement Pro VA Income Advantage Payment Selection/Change Form - USA-1577-NJ, Retirement Pro VA Required Minimum Distribution (RMD) - USA-1585, Retirement Pro VA Systematic Withdrawal - USA-1578, Retirement Pro VA Withdrawal Request - USA-1597, RFA Qualified Plan Acknowledgement Form and ERISA Disclosure - RFA-ERPOS, Rollover Notice - 403(b) - SFAL-0002-NY [NY], Rollover Notice Regarding Retirement Plan Payments - PLI-095-NY [NY], Sep IRA Excess Contribution Removal Form - USA-1507 [Generic], Sep IRA Excess Contribution Removal Form - USA-1507-NY [NY], SEP or SIMPLE Excess Contribution Removal Form - S2234, Settlement for Annuity Benefits - S2043-NY [NY], Simple Income II Rider Statement of Understanding - SOU91050-2 [DE-IA-MN-OH], Source of Payment (Fixed) - NBAL0041-NY [NY], Source of Payment (Variable) - NBAL0041-NY [NY], State Withholding Tax Guide - NBAL0035-NY [NY], Statement of Understanding - Death Benefit Rider - NB2222 [Generic], Statement of Understanding - Death Benefit Rider - NB2222-AZ [AZ], Statement of Understanding - Death Benefit Rider - NB2222-MT [MT], Statement of Understanding - Death Benefit Rider - NB2222-OK [OK], Statement of Understanding - Flexible Withdrawal Rider - SOU95178-1 [Generic], Statement of Understanding - Flexible Withdrawal Rider - SOU95178-1-PA [PA], Statement of Understanding/Preliminary Contr. We will mail Form 5498 by January 31, 2023. Requests for a withdrawal from a fixed annuity can be made online. 1 hours ago The IRS requires the use of specific distribution codes for different types of payments, which need to be reported separately. In addition, we continue to identify and provide new tools and technologies to help us stay connected with each other and our customers. Yes. If you have more than one Allianz contract, please verify that you have specified the correct contract number. If you choose to assign your long-term care insurance benefits to a covered provider, you must submit the Direction to Once youve registered your account online, you can log in and use our Price & Performancetool which provides detailed variable investment option performance. like to grant access to your policy information to someone else, please print, complete, and mail the attached form to our Life insurance 763.582.6002 The surrender value is paid to the policyholder at the time of surrender. Annuities: If this form is not submitted with your claim form it may delay our handling of your claim. You can also download it, export it or print it out. You can also ask your tax professional if an RMD is required from your contract. Any determination that is to be made, such as to policy values, beneficiary, claim eligibility, or policy status, will take place. ABC Lifetime Withdrawal Election Form - S2301. This checklist does not, If you choose to assign your long-term care insurance benefits to your covered provider, this form is required from your, Authorization to Release Medical Information, W-9 Request for Taxpayer Identification Number and Certification. We've got more versions of the allianz beneficiary change form form. This form is designed to help you stay organized while submitting a new nursing facility claim. Learn more about annuities. Typically, the Fair Market Value (FMV) in Box 5 is the only information provided.