FULL OR PARTIAL WITHDRAWAL REQUEST INSTRUCTIONS …

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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. Check boxes are provided below to guide you as you complete each section of the Good orderPlease refer to this section of the form for important information .

Please refer to this section of the form for important information. For Employee Retirement Security Income (ERISA) plans only, complete and attach a Spousal Consent form. If the appropriate documentation or information is not received, your request may be considered not in good order, e.g., Hardship withdrawal documentation.

  Information, Important, Important information, Withdrawal