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Policy loan request - New York Life

This form continues on the next page 21135PL (05/2021) 1 Maximum loan available $ (please specify amount requested) To pay the premium (plus any Policy loan interest) due / / for this Policy or Policy number Before taking any loans from your Policy , you should contact your New york life agent or call Customer Service at 1-800-CALL-NYL for an illustration showing the impact of the loan on your specific Policy . Important information about Policy total outstanding loan balance (which includes accrued loan interest) reduces your Policy s available cash surrender value and life insurance benefit. The amount you borrow will accrue interest daily. Any loan interest that you do not pay when due will be added to the Policy s outstanding loan principal and will also accrue interest daily. Policy loan interest is due on the dates specified in your Policy . The interest rate will never be more than the maximum loan interest rate stated in your Policy .

Oregon, Vermont , Virginia and Washington, DC: As of January 1, 2018, state withholding is generally required if federal income tax is being withheld. For residents of Arkansas, California, Georgia, Maine, North Carolina, Oregon, and Vermont: If federal income tax is being withheld, state income tax

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