Transcription of FULL OR PARTIAL WITHDRAWAL REQUEST INSTRUCTIONS …
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FULL OR PARTIAL WITHDRAWAL REQUEST INSTRUCTIONS …
INSTRUCTIONS - Page 1 of 2 Order #119324 07/12/2021 TM: DISTRIBMNTFULL OR PARTIAL WITHDRAWAL REQUEST INSTRUCTIONSFIXED/VARIABLE ANNUITIESR eliaStar 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 06144-1559 Phone: 877-884-5050 Use 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.
c C. Hardship Withdrawal c Specific Dollar Amount $ _____ c Maximum hardship amount available Minimum withdrawal limits apply. Any withdrawal may be subject to a withdrawal charge and/or positive or negative market value adjustment (MVA). Please refer to your contract for more detailed information regarding the impact of withdrawals from
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