FULL OR PARTIAL WITHDRAWAL REQUEST INSTRUCTIONS ...
INSTRUCTIONS - Page 1 of 2 Order #119324 07/12/2021 TM: DISTRIBMNTFULL OR PARTIAL WITHDRAWAL REQUEST INSTRUCTIONSFIXED/VARIABLE ANNUITIESReliaStar Life Insurance Company (Home Office: Minneapolis, MN)ReliaStar Life Insurance Company of New York (Home Office: Woodbury, NY)(the Company )Members of the Voya family of companiesCustomer Service: PO Box 1559, Hartford, CT 06144-1559Phone: 877-884-5050Use this form to REQUEST a WITHDRAWAL under the provisions of your annuity contract. Do not use this form to REQUEST a rollover, transfer, or exchange to another company. Please follow INSTRUCTIONS to avoid delays in processing your REQUEST . A distribution is a tax reportable event that may not be reversed.
If completing this section, do not complete section 3. c reASoN For WITHdrAWAL Complete this section if the contract is a 403(b) or 401(a), or if the withdrawal is subject to a waiver of withdrawal charge due to disability or termination of employment as defined by the contract or prospectus. Also complete this section if you are requesting
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