Axa 1035 Exchange – Fill Out and Use This PDF

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Axa 1035 Exchange – Fill Out and Use This PDF

The AXA 1035 Exchange form is a crucial document for those looking to execute a direct transfer, contract exchange, or direct rollover of TSA (Tax Sheltered Annuity) assets to another carrier. Recognized for its role in facilitating these transactions efficiently, the form serves as the only accepted document by AXA Equitable for these specific purposes. For individuals aiming to optimize their investment portfolios or navigate their retirement planning strategies, understanding the nuances of this form and its proper application is essential.

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Axa 1035 Exchange PDF Details

Navigating the complexities of retirement accounts and investments involves a multitude of strategic decisions, particularly when considering the transition or reallocation of assets. Within this labyrinth of choices, the Axa 1035 Exchange form represents a critical pathway for individuals seeking to maneuver their tax-sheltered annuity assets without the immediate tax implications that typically accompany such financial maneuvers. Specifically, this document facilitates the direct transfer, contract exchange, or direct rollover of Tax-Sheltered Annuity (TSA) assets to another carrier, providing a streamlined mechanism under the guidelines established by Section 1035 of the Internal Revenue Code. The EQUI-VEST® Variable Annuity Series offered by AXA Equitable lays out a framework within this document for executing such transactions, catering to a variety of strategic reshuffling of one's investment portfolio. Whether through express or regular mail, or even fax, the form stands as a vital tool for repositioning assets with an eye towards preserving tax advantages while aiming to meet the evolving investment goals and risk tolerance of the annuity owner. Accompanied by detailed instructions for completing various sections—ranging from owner's information to the destination of funds, and the specific type of transaction—this form embodies a pivotal aspect of investment strategy execution in the realm of tax-advantaged retirement assets.

Question	Answer
Form Name	Axa 1035 Exchange
Form Length	6 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 30 sec
Other names	equitable 403b rollover form, axa equitable rollover form, equitable transfer form, axa equitable variable transfer exchange

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EQUI-VEST®

Variable Annuity Series

Direct Transfer/Contract Exchange or Direct Rollover of TSA Assets to Another Carrier

Express Mail:

AXA Equitable

EQUI-VEST Processing Ofﬁce

100 Madison St., Suite 1000

Syracuse, N.Y. 13202

Regular Mail:

AXA-Equitable

EQUI-VEST Processing Ofﬁce

P.O Box 4956

Syracuse, N.Y. 13221

Fax Number:

(201) 583-2683

For Assistance: Call (800) 628-6673

!"#$%&'(')*+,-$%&'./00'%121'('3/00'4121'56)

7,8$%&'./00'%121'('9/00'4121'56)

Current Online Transactions: 7>>#"99,!4(+?"9U, 7;;*'($%*+,!4(+?"9U,1*;;(#,!*9$,7R"#(?%+?,:"$,]B9U, P+W.%#%"9U,:29$"/($%',799"$,Q"0(;(+'%+?U,O#(+9F"#9

1. Owner’s Information

!"#$%&'($")!*+$#('$,-./0"#,		1(2$%/",34*+",-./0"#

56+"#)7++.%$(+$89,-(/",		:'%(;,:"'.#%$2,-./0"#,<;(9$,=,>%?%$9,+;2@

A/(%;,7>>#"99

7>>#"99,-./0"#,(+>,:$#""$,	,	7B$):.%$")C;**#

!%$2,,	:$($",,	D%B,!*>"
,3;"(9",'4"'E,%F,$4%9,%9,(+,7>>#"99,!4(+?"G

2A. Type of Transaction

Check One Transaction

1.Direct Transfer:

,, ,TSA to TSA — 1%#"'$,B;(+H$*HB;(+,$#(+9F"#,F#*/,*+",=IJ<0@,3;(+,$*,(+*$4"#,=IJ<0@,3;(+G,K*$4,2*.#,F*#/"#, "/B;*2"#,<*#,B;(+,(>/%+%9$#($*#,*#,*$4"#,(.$4*#%L">,B"#9*+@,(+>,2*.#,'.##"+$,"/B;*2"#,<*#,B;(+,(>/%+%9$#($*#,*#, *$4"#,(.$4*#%L">,B"#9*+@,6%;;,+"">,$*,(.$4*#%L",$4%9,$#(+9('$%*+,%+,:"'$%*+,MKG

2.Contract Exchange:

,, TSA to TSA —,!*+$#('$,"N'4(+?",F#*/,*+",O:7,(++.%$2,'*+$#('$,$*,(+*$4"#,P+$"#+(;,Q"R"+.",!*>",:"'$%*+, =IJ<0@,(++.%$2,'*+$#('$,<%+';.>%+?,(,=IJ<0@<S@,'.9$*>%(;,(''*.+$@,6%$4%+,$4",9(/",B;(+G,T",6%;;,+"">,$4", (.$4*#%L($%*+,*F,$4","/B;*2"#,64%'4,9B*+9*#">,2*.#,O:7,'*+$#('$U,.+;"99,7V7,AW.%$(0;",4(9,0""+,B#*R%>">,

6%$4,>*'./"+$($%*+,(9,$*,(BB#*R">,B#*R%>"#9,F#*/,$4","/B;*2"#,(+>,$4",$#(+9F"#"",B#*R%>"#,%9,%+';.>">,%+,9.'4, >*'./"+$($%*+G,:"",:"'$%*+,MKG

3.Direct Rollover from TSA:

,, Direct Rollover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ote:,T",'(++*$,B#*'"99,$4%9,#"W."9$,%F,F.+>9,(#",9.0Z"'$,$*,6%$4>#(6(;,#"9$#%'$%*+9G

Destination of Funds — Indicate Type of Retirement Plan:

,,,[.(;%&">,3;(+,,,,,,,,,,,PQ7,,,,,,,,,,,,,\*R"#+/"+$(;,=MS,A1!,,,,,,,,,,O:7

4.Rollover Conversion from TSA:

,, Rollover Conversion to Roth IRA — !*+R"#9%*+,#*;;*R"#,F#*/,(,O:7,(++.%$2,'*+$#('$,%+$*,(,Q*$4,PQ7,%99.">, 02,(+*$4"#,'(##%"#G,O4","/B;*2"#,<*#,B;(+,(>/%+%9$#($*#,*#,*$4"#,(.$4*#%L">,B"#9*+@,9B*+9*#%+?,$4",B;(+,64%'4,%9, $4",9*.#'",*F,F.+>9,6%;;,+"">,$*,(.$4*#%L",$4%9,$#(+9('$%*+,%+,:"'$%*+,MKG,Note:,T",'(++*$,B#*'"99,$4%9,#"W."9$,%F, F.+>9,(#",9.0Z"'$,$*,6%$4>#(6(;,#"9$#%'$%*+9G

Trns/Exchange/Rollover	X01806_core_f	Cat.# 139737 (09/13)
	Page 1 of 6

2B. Amount to be Transferred/Exchanged or Rolled Over*		(Check One Box Only)

,	, ,Partial Transfer/Exchange or Rollover,*F,^,		G,<7,/%+%/./,7++.%$2,7''*.+$,_(;.",/.9$,

	#"/(%+,%+,$4",!+$#('$G,:"",$4",B#9B"'$.9,F*#,>"$(%;9G@,

PF,2*.,6%94,9B"'%&',>*;;(#,(/*.+$9,$*,0",6%$4>#(6+,F#*/,$4",\.(#(+$"">,P+$"#"9$,5B$%*+,(+>)*#,$4",_(#%(0;",P+R"9$/"+$, 5B$%*+9U,'*/B;"$",0";*6G,PF,2*.,>*,+*$,'*/B;"$",$4%9,9"'$%*+U,(/*.+$9,6%;;,0",6%$4>#(6+,*+,(,B#*,#($(,0(9%9G P+%$%(;,'*+$#%0.$%*+9,(+>)*#,$#(+9F"#9,$*,$4",3"#9*+(;,P+'*/",K"+"&$,<3PK@,_(#%(0;",P+R"9$/"+$,5B$%*+9,'(+,*+;2,0", /(>",02,.9%+?,$4",(BB;%'(0;",`:";"'$%*+,*F,$4",3"#9*+(;,P+'*/",K"+"&$,<3PK@,C*#/a,;*'($">,*+,"15VG

Asset Allocation

AXA Allocation

$AXA Aggressive Allocation (18*)

$AXA Balanced Strategy (8Q*)

$AXA Conservative Allocation (15*)

$AXA Conservative Growth Strategy (8R*)

$AXA Conservative-Plus Allocation (16*)

$AXA Conservative Strategy (8S*)

$AXA Moderate Allocation (T4*)

$AXA Moderate Growth Strategy (8O*)

$AXA Moderate-Plus Allocation (17*)

Target Allocation

$Target 2015 Allocation (6G*)

$Target 2025 Allocation (6H*)

$Target 2035 Allocation (6I*)

$Target 2045 Allocation (6J*)

Other Asset Allocation

$All Asset Aggressive Alt 25 (8T*)

$All Asset Growth – Alt 20 (7H*)

$All Asset Moderate Growth Alt 15 (8U*)

$EQ/AllianceBernstein Dynamic Wealth Strategies (8P*)

$EQ/Franklin Templeton Allocation (6P*)

Bonds

$American Funds Insurance Series Bond (8V*)5

$EQ/Core Bond Index (96*)

$EQ/Global Bond PLUS (47*)

$EQ/High Yield Bond (8X*)

$EQ/Intermediate Government Bond (TI*)1

$EQ/PIMCO Global Real Return (8Y*)

$EQ/PIMCO Ultra Short Bond (28*)

$EQ/Quality Bond PLUS (TQ*)

$Invesco V.I. High Yield (8L*)5

$Ivy Funds VIP High Income (8G*)5

$Multimanager Core Bond (69*)

$Multimanager Multi-Sector Bond (TH*)

$Templeton Global Bond Securities (8F*)2,5

Cash Equivalents

$EQ/Money Market (T3*)

Guaranteed-Fixed

$Guaranteed Interest Option (A1*)

International Stocks/Global

$AXA Tactical Manager International (7N*)

$EQ/Emerging Markets Equity PLUS (8W*)

$EQ/Global Multi-Sector Equity (78*)

$EQ/International Core PLUS (88*)

$EQ/International Equity Index (TN*)1

$EQ/International Value PLUS (73*)

$EQ/MFS International Growth (26*)

$EQ/Oppenheimer Global (6A*)

$EQ/Templeton Global Equity (6D*)

$Invesco V.I. International Growth (7Z*)5

$Lazard Retirement Emerging Markets Equity (8H*)5

$MFS® International Value (8A*)5

$Multimanager International Equity (65*)1

Large Cap Stocks

$AXA Tactical Manager 500 (7M*)

$EQ/BlackRock Basic Value Equity (81*)

$EQ/Boston Advisors Equity Income (33*)

$EQ/Calvert Socially Responsible (92*)

$EQ/Capital Guardian Research (86*)3

$EQ/Common Stock Index (T1*)

$EQ/Davis New York Venture (6Q*)

$EQ/Equity 500 Index (TE*)

$EQ/Equity Growth PLUS (94*)

$EQ/Invesco Comstock (07*)1

$EQ/JPMorgan Value Opportunities (72*)

$EQ/Large Cap Core PLUS (85*)

$EQ/Large Cap Growth Index (82*)

$EQ/Large Cap Growth PLUS (77*)

$EQ/Large Cap Value Index (49*)

$EQ/Large Cap Value PLUS (89*)1

$EQ/Lord Abbett Large Cap Core (05*)

$EQ/Montag & Caldwell Growth (34*)1

$EQ/Mutual Large Cap Equity (6F*)

$EQ/T. Rowe Price Growth Stock (32*)

$EQ/UBS Growth and Income (35*)3

$EQ/Wells Fargo Omega Growth (83*)3

$Fidelity® VIP Contrafund® (7R*)5

$Invesco V.I. Diversiﬁed Dividend (8B*)2,5

$MFS® Investors Growth Stock (8I*)5

$MFS® Investors Trust (7P*)5

$Multimanager Aggressive Equity (T2*)

$Multimanager Large Cap Core Equity (57*)3

$Multimanager Large Cap Value (58*)

$Oppenheimer Main Street Fund/VA (7Q*)2,5

:;,-"#%<'=#>"2;'?;#;@A'B:=?C'D%,8%E<;'=#F;-A2;#A'

Options

$PIB AXA Moderate Growth Strategy (Q1*)4

$PIB EQ/AllianceBernstein Dynamic Wealth Strategies (Q2*)4

$PIB AXA Balanced Strategy (Q3*)4

$PIB AXA Conservative Growth Strategy (Q4*)4

$PIB AXA Conservative Strategy (Q5*)4

Sector/Specialty

$EQ/Franklin Core Balanced (6C*)

$EQ/GAMCO Mergers and Acquisitions (25*)3

$Invesco V.I. Global Real Estate (8C*)5

$Ivy Funds VIP Energy (8D*)5

$MFS® Technology (8J*)5

$MFS® Utilities (8K*)5

$Multimanager Technology (67*)

$PIMCO VIT CommodityRealReturn® Strategy (8E*)2,5

$Van Eck VIP Global Hard Assets (8N*)5

Small/Mid Cap Stocks

$American Century VIP Mid Cap Value (7V*)2,5

$AXA Tactical Manager 400 (7L*)

$AXA Tactical Manager 2000 (7K*)

$EQ/AllianceBernstein Small Cap Growth (TP*)

$EQ/AXA Franklin Small Cap Value Core (6E*)

$EQ/GAMCO Small Company Value (37*)

$EQ/Mid Cap Index (55*)

$EQ/Mid Cap Value PLUS (79*)

$EQ/Morgan Stanley Mid Cap Growth (08*)

$EQ/Small Company Index (97*)

$Fidelity VIP Mid Cap (7U*)2,5

$Goldman Sachs VIT Mid Cap Value (7W*)5

$Invesco V.I. Mid Cap Core Equity (7T*)5

$Invesco V.I. Small Cap Equity (7X*)5

$Ivy Funds VIP Mid Cap Growth (8M*)5

$Ivy Funds VIP Small Cap Growth (7Y*)5

$Multimanager Mid Cap Growth (59*)1

$Multimanager Mid Cap Value (61*)1

$Multimanager Small Cap Growth (36*)1

$Multimanager Small Cap Value (91*)1

Structured Investment Option

$Segment Holding Account for S&P 500 1yr -10% Buffer (V1*)4

$Segment Holding Account for S&P 500 3yr -20% Buffer (V3*)4

$Segment Holding Account for S&P 500 5yr -20% Buffer (V5*)4

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Y, 7R(%;(0;",F*#,A[]PH_A:O,<:"#%"9,YIX@,(+>,A[]PH_A:O,:$#($"?%"9,<:"#%"9,cIX@,*+;2G

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=, 7R(%;(0;",F*#,A[]PH_A:O,<:"#%"9,YIX@U,A[]PH_A:O,:$#($"?%"9,<:"#%"9,cII@,(+>,A[]PH_A:O,:$#($"?%"9,<:"#%"9,cIX@,*+;2G M, _PO,F.+>9,(#",+*$,(R(%;(0;",%+,O"N(9,F*#,B.0;%',9'4**;9,(+>,*B"+,"+#*;;/"+$,'4(#$"#,9'4**;9,<dHXY@G

e, C%N">,f($.#%$2,5B$%*+,<Cf5@,g,:B"'%F2,$4",3"#%*>,(+>,7/*.+$,*F,T%$4>#(6(;G,C.+>9,6%;;,0",6%$4>#(6+,F#*/,$4",Cf5, *+;2,64"+,$4"#",(#",%+9.F&'%"+$,F.+>9,%+,$4",*$4"#,%+R"9$/"+$,*B$%*+9,.+>"#,$4",'*+$#('$,$*,9($%9F2,$4",$#(+9F"#)"N'4(+?", *#,B(#$%(;,#*;;*R"#U,%F,$4",Cf5,%9,$4",*+;2,%+R"9$/"+$,*B$%*+,9";"'$">U,*#,%F,(+,(/*.+$,4(9,0""+,9B"'%&">,$*,0",6%$4>#(6+, F#*/,$4",Cf5,(9,%+>%'($">,0";*6G,PF,/*+"2,%9,6%$4>#(6+,F#*/,$4",Cf5,B#%*#,$*,/($.#%$2U,%$,6%;;,0",9.0Z"'$,$*,(,/(#E"$, R(;.",(>Z.9$/"+$,(+>,6%$4>#(6(;,'4(#?"9U,%F,(BB;%'(0;"G

,	C%N">,f($.#%$2,5B$%+,h,3"#%>,		,	^	,,	C%N">,f($.#%$2,5B$%+,h,3"#%>,		,	^
,	,	/($.#%$2,2"(#,					/($.#%$2,2"(#
,	C%N">,f($.#%$2,5B$%+,h,3"#%>,		,	^	,,	C%N">,f($.#%$2,5B$%+,h,3"#%>,		,	^
,	,	/($.#%$2,2"(#,					/($.#%$2,2"(#

, ,Total Transfer/Exchange or Rollover *F,$4","+$%#",'(94,R(;.",*F,$4",!*+$#('$,+./0"#,%+,:"'$%*+,XG,<O4",!*+$#('$, /.9$,0",#"$.#+">,6%$4,$4%9,F*#/G@

,,!4"'E,4"#",%F,2*.,9";"'$">,(,$*$(;,$#(+9F"#)"N'4(+?",*#,#*;;*R"#,(+>,(#",.+(0;",$*,;*'($",2*.#,'*+$#('$G

b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

Trns/Exchange/Rollover	X01806_core_f	Cat.# 139737 (09/13)
	Page 2 of 6

3. Acceptance of Transfer/Exchange or Rollover !"#$%#&"'()%*%+#$,#-.&&%--"/#0+.&12/,

O4%9,9"'$%*+,/.9$,0",'*/B;"$">,02,$4",%99."#,*F,$4",P+$"#+(;,Q"R"+.",!*>",:"'$%*+,=IJ<0@,(++.%$2,'*+$#('$,*#,=IJ<0@<S@, '.9$*>%(;,(''*.+$,$4($,6%;;,#"'"%R",$4",>%#"'$,O:7,$#(+9F"#)'*+$#('$,"N'4(+?",*#,*$4"#,";%?%0;",#"$%#"/"+$,B;(+,$4($,6%;;,#"'"%R", $4",>%#"'$,#*;;*R"#,<?"+"#(;;2,ii9.''"99*#,&>.'%(#288@G

NOTE: This is the only form that AXA Equitable will accept for direct transfer/contract exchange or direct rollover requests.

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-(/",*F,:.''"99*#,C%>.'%(#2

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!*+$('$,3"#9*+,*#,7$$"+$%*+,*F,<1"B(#$/"+$@

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Trns/Exchange/Rollover	X01806_core_f	Cat.# 139737 (09/13)
	Page 3 of 6

4.Representations and Acknowledgements 3!"#$%#&"'()%*%+#$,#244.1*24*5"64%/7#-%%#%8&%(*1"4#9"/#-(".-%-#14#:;<=

A. For Direct TSA Transfers/Contract Exchanges

K2,/2,9%?+($.#",0";*6U,P,('E+*6;">?"j

e, 7V7,AW.%$(0;",4(9,%+F*#/">,/",$4($j,$4",O#"(9.#2,1"B(#$/"+$,(+>,$4",PQ:,4(R",%99.">,&+(;,O#"(9.#2, Q"?.;($%*+9,.+>"#,:"'$%*+,=IJ<0@,*F,$4",P+$"#+(;,Q"R"+.",!*>",*+,k.;2,YmU,YIIS,(+>,$4"9",#"?.;($%*+9,6%;;, #"R*E",%+>%R%>.(;H%+%$%($">,Q"RG,Q.;,cIhY=,>%#"'$,$#(+9F"#9,F#*/,*+",=IJ<0@,O:7,(++.%$2,'*+$#('$,$*,(+*$4"#,=IJ<0@, O:7,(++.%$2,'*+$#('$,(9,*F,k(+.(#2,XU,YIIcG,]+>"#,O#"(9G,Q"?G,:"'G,=IJ<0@hXIU,(;;,=IJ<0@,O:7,'*+$#('$9,/.9$,0", B(#$,*F,(+,"/B;*2"#,B;(+,(9,*F,k(+.(#2,XU,YIIcG,PF,(,=IJ<0@,O:7,'*+$#('$,%9,%99.">,(F$"#,:"B$"/0"#,Y=U,YIIS,(9,(, >%#"'$,$#(+9F"#)'*+$#('$,"N'4(+?"j

g,O4",B;(+,.+>"#,64%'4,$4",'*+$#('$,%9,%99.">,/.9$,B#*R%>",F*#,$4",$#(+9F"#n

g,,O4",(''./.;($">,0"+"&$,.+>"#,$4",$#(+9F"#"",'*+$#('$,/.9$,0",($,;"(9$,"W.(;,$*,$4",(''./.;($">,0"+"&$, %//">%($";2,0"F*#",$4",$#(+9F"#n,(+>

g,,O4",%99."#,*F,$4",$#(+9F"#"",'*+$#('$,/.9$,0",(+,(BB#*R">,B#*R%>"#,.+>"#,$4","/B;*2"#89,B;(+,*#,$4",, "/B;*2"#,/.9$,4(R",(+,%+F*#/($%*+,94(#%+?,(?#""/"+$,"9$(0;%94">,6%$4,$4",%99."#,*F,$4",$#(+9F"#"",'*+$#('$,, 02,k(+.(#2,XU,YIIcG

e, PF,$4"9",'*+>%$%*+9,(#",+*$,/"$,02,k(+.(#2,XU,YIIc,$4",=IJ<0@,'*+$#('$,%99.">,%+,$4",B*9$H:"B$"/0"#,Y=U,YIIS, $#(+9F"#)"N'4(+?",/(2,0"'*/",$(N(0;",($,$4($,$%/",(+>,+*,F.#$4"#,$(NHF#"","N'4(+?"9,/(2,0",/(>",F#*/,$4($, '*+$#('$,$*,(+*$4"#,=IJ<0@,'*+$#('$G,C.#$4"#U,+*,#*;;*R"#9,/(2,0",/(>",F#*/,$4($,'*+$#('$,$*,(+,";%?%0;",#"$%#"/"+$, B;(+,9.'4,(9,(+,PQ7G

B. For Direct Rollovers

K2,/2,9%?+($.#"U,P,#"B#"9"+$,$4($j

e,, P,4(R",'4"'E">,6%$4,$4",3;(+,7>/%+%9$#($*#,(+>,4(R",>"$"#/%+">,$4($,$4",B;(+,(''"B$9,#*;;*R"#9,*F,$4%9,$2B"G,, P,4(R",>%9'.99">,$4%9,$#(+9('$%*+,6%$4,/2,$(N,(>R%9*#U,(+>,P,.+>"#9$(+>,$4($,$4",F.+>9,6%;;,0",9.0Z"'$,$*,$4",#.;"9, *F,$4",+"6,B;(+,*#,'*+$#('$G

e, P,(/,+*$,#*;;%+?,*R"#,(+2,(F$"#H$(N,'*+$#%0.$%*+9U,"N'"B$,(9,9B"'%&'(;;2,B"#/%$$">,(+>,>*'./"+$">G

e, P,4(R",$(E"+,$4",#"W.%#">,/%+%/./,>%9$#%0.$%*+U,%F,(+2U,B.#9.(+$,$*,P+$"#+(;,Q"R"+.",!*>",:"'$%*+,=IX<(@<c@,(+>, #";($">,F">"#(;,$(N,#.;"9G

e,O4",:.''"99*#,C%>.'%(#289,B;(+,*#,'*+$#('$,+(/">,%+,:"'$%*+,J,W.(;%&"9,(9,(+,";%?%0;",#"$%#"/"+$,(##(+?"/"+$G

e, P,('E+*6;">?",4(R%+?,#"'"%R">U,#"(>,(+>,.+>"#9$**>U,(,+*$%'",F#*/,$4",3;(+,7>/%+%9$#($*#,*#,3(2*#U,64%'4,"NB;(%+9, $4",F">"#(;,%+'*/",$(N,#.;"9,(+>,*B$%*+9,64%'4,(BB;2,$*,";%?%0;",#*;;*R"#,>%9$#%0.$%*+9U,%+';.>%+?,(,>"9'#%B$%*+,*F,$4", >%#"'$,#*;;*R"#,*B$%*+G,AR"+,%F,P,4(R",+*$,#"'"%R">,$4%9,"NB;(+($%*+,($,;"(9$,JI,>(29,0"F*#",P,#"W."9$,$4",>%9$#%0.$%*+,$*, 0",/(>"U,(9,#"W.%#">,02,$4",PQ:U,P,(/,+"R"#$4";"99,(F/($%R";2,";"'$%+?,$*,/(E",(,>%#"'$,#*;;*R"#G

e, PF,2*.,(#",+"%$4"#,$4",56+"#,+*#,$4",7++.%$(+$U,'4"'E,64%'4"R"#,(BB;%"9j

, P,(/,";%?%0;",$*,/(E",$4%9,>%#"'$,#*;;*R"#,(9j

, 9.#R%R%+?,9B*.9",0"+"&'%(#2,*F,>"'"(9">,7++.%$(+$U,*#

, 9B*.9",*#,F*#/"#,9B*.9",#"'"%R%+?,>%9$#%0.$%*+,.+>"#,(,[.(;%&">,1*/"9$%',Q";($%*+9,5#>"#,*F,ii[1Q5G88,

,<O*,B#*'"99,$4%9U,6",/.9$,#"'"%R",>%#"'$%*+9,F#*/,$4",3;(+,7>/%+%9$#($*#,(+>,#"'"%R",(,'*B2,*F,$4",[1Q5G@

Trns/Exchange/Rollover	X01806_core_f	Cat.# 139737 (09/13)
	Page 4 of 6

4. Representations and Acknowledgements

C. For Conversion Rollovers

7V7,AW.%$(0;",%9,#"W.%#">,$*,6%$44*;>,F">"#(;,%+'*/",$(N,*+,B(2/"+$9,F#*/,(++.%$2,'*+$#('$9,64%'4,/(2,0",%+';.>">,%+, ?#*99,%+'*/"G,3;"(9",'4"'E,$4",(BB#*B#%($",0*N,0";*6,(+>,B#*R%>",2*.#,]G:G,#"9%>"+'",(>>#"99,(+>,2*.#,O(NB(2"#89, P>"+$%&'($%*+,-./0"#,$*,";"'$,*.$,*F,6%$44*;>%+?G

, P,6%94,$*,";"'$,*.$,*F,6%$44*;>%+?G,]+>"#,B"+(;$2,*F,B"#Z.#2U,P,'"#$%F2,$4($,$4",F*;;*6%+?,O(NB(2"#,P>"+$%&'($%*+, -./0"#,%9,'*##"'$j, , :G:G-, , AGPG-G, , 5$4"#

, P,6%94,$*,4(R",YIo,6%$44";>,F#*/,/2,'*+R"#9%*+,(/*.+$G

PF,2*.#,(>>#"99,*F,#"'*#>,%9,+*$,(,]G:G,#"9%>"+'",(>>#"99U,'*/B;"$",$4",F*;;*6%+?,9$($"/"+$j, <'4"'E,*+"@j, , P,(/,(,]G:G,'%$%L"+G, , P,(/,+*$,(,]G:G,'%$%L"+U,P,#"9%>",%+

, ,

<+(/",*F,'*.+$#2@

PF,2*.,(#",F*#"%?+U,2*.,/(2,+"">,$*,'*/B;"$",(>>%$%*+(;,$(N,F*#/9,0"F*#",2*.#,$#(+9('$%*+,'(+,0",B#*'"99">G K2,/2,9%?+($.#"U,P,#"B#"9"+$,$4($j

e, P,.+>"#9$(+>,$4($,%F,P,";"'$,*.$,*F,6%$44*;>%+?U,XIIo,*F,$4",(/*.+$,#"W."9$">,$*,0",'*+R"#$">,6%;;,0",(BB;%">,$*,/2, Q*$4,PQ7G

e, P,.+>"#9$(+>,$4($,%F,P,>*,+*$,";"'$,*.$,*F,6%$44*;>%+?U,$4",(/*.+$,*F,>""/">,6%$4>#(6(;,F#*/,/2,$#(>%$%*+(;,PQ7U, *#,7BB;%'(0;",3;(+U,+"$,*F,$4",(BB#*B#%($",(/*.+$,*F,F">"#(;,(+>,(+2,(BB;%'(0;",9$($",%+'*/",$(N,6%$44";>U,6%;;,0", F*#6(#>">,$*,/2,+"6,'(##%"#,F*#,(BB;%'($%*+,$*,/2,+"6,Q*$4,PQ7G

e, O4",:.''"99*#,C%>.'%(#289,(++.%$2,'*+$#('$,*#,(''*.+$,+(/">,%+,:"'$%*+,JU,W.(;%&"9,(9,(+,P+$"#+(;,Q"R"+.",!*>", :"'$%*+,=Il,%+>%R%>.(;,#"$%#"/"+$,(##(+?"/"+$,*#,%F,(BB;%'(0;"U,(,Q*$4,PQ7,.+>"#,PQ!,:"'$%*+,=Il7G

D. For All Transactions

K2,/2,9%?+($.#",0";*6U,P,('E+*6;">?",$4($j

e, P,(/,$4",56+"#,*F,$4",!*+$#('$,;%9$">,%+,:"'$%*+,XG,PF,P,(/,+*$U,/2,%+$"#"9$,%9,>"#%R">,F#*/,(,B(#$%'%B(+$,%+,(,=IJ<0@, B;(+,(+>,$4","/B;*2"#,*#,3;(+,7>/%+%9$#($*#,4(9,(BB#*R">,$4%9,$#(+9('$%*+,%+,:"'$%*+,MKn

e, T%$4>#(6(;,'4(#?"9,(9,9B"'%&">,%+,$4",!*+$#('$,/(2,0",%/B*9">,*+,$4",7++.%$2,7''*.+$,_(;.",*F,/2,7++.%$2, !*+$#('$,B#%*#,$*,$4%9,$#(+9('$%*+,(+>U,('E+*6;">?",$4($,%$,/(2,+*$,0",%+,/2,0"9$,%+$"#"9$,$*,0"?%+,(,+"6,6%$4>#(6(;, '4(#?",9'4">.;",.+>"#,(,+"6,!*+$#('$,*#,*$4"#,(##(+?"/"+$,6%$4,$4",:.''"99*#,C%>.'%(#2n

e, 7+2,4%?4"#,%+R"9$/"+$,#"$.#+,64%'4,/(2,*''.#,(9,(,#"9.;$,*F,$4%9,$#(+9('$%*+,/(2,0",*.$6"%?4">,02,(BB;%'(0;", 6%$4>#(6(;,'4(#?"9,(99"99">,(?(%+9$,$4",7++.%$2,7''*.+$,_(;.",*F,/2,7++.%$2,!*+$#('$,9B"'%&">,%+,:"'$%*+,Xn

e, P,.+>"#9$(+>,$4($,P,(/,#"9B*+9%0;",F*#,>"$"#/%+%+?,/2,";%?%0%;%$2,$*,$#(+9F"#)"N'4(+?",*#,#*;;,*R"#,6%$4%+,$4",;%/%$9,9"$, F*#$4,02,$(N,;(69U,#";($">,#"?.;($%*+9,(+>,B;(+,(?#""/"+$9G,P,(99./",#"9B*+9%0%;%$2,F*#,(+2,$(N,'*+9"W."+'"9,*#, B"+(;$%"9,$4($,/(2,(BB;2,$*,$4",$#(+9F"#)"N'4(+?",*#,#*;;,*R"#,*F,/2,(99"$9G

e, 7V7,AW.%$(0;",4(9,+*$,?%R"+,/",$(N,(>R%'",%+,'*++"'$%*+,6%$4,$4%9,$#(+9('$%*+,(+>,4(9,>%#"'$">,/",$*,'*+9.;$,6%$4, /2,*6+,$(N,*#,;"?(;,(>R%9"#,(+>U,P,4*;>,7V7,AW.%$(0;",4(#/;"99,F#*/,(+2,%+'*/",*#,"N'%9",$(N,;%(0%;%$2U,%+';.>%+?, B"+(;$%"9U,+"?($%R",%+R"9$/"+$,"NB"#%"+'",(+>,%+$"#"9$,(9,(,#"9.;$,*F,$4%9,$#(+9('$%*+G

e, 7V7,AW.%$(0;",6%;;,>">.'$,(,B#*'"99%+?,F"",*F,.B,$*,^mMU,>"B"+>%+?,*+,!*+$#('$,/(#E"$,(+>,9"#%"9G

e, P,.+>"#9$(+>,$4($,$4",>%#"'$,$#(+9F"#)"N'4(+?",*#,>%#"'$,#*;;*R"#,6%;;,0","FF"'$%R",*+,$4",>($",$4($,$4%9,F*#/U,B#*B"#;2, '*/B;"$">,6%$4,(;;,#"W.%#">,9%?+($.#"9,%9,#"'"%R">,($,7V7,AW.%$(0;"89,3#*'"99%+?,5F&'"G,P,(;9*,.+>"#9$(+>,$4($,.B*+, #"'"%B$,*F,$4",B#*B"#;2,'*/B;"$">,F*#/9U,7V7,AW.%$(0;",4(9,M,0.9%+"99,>(29,$*,B#*'"99,$4%9,#"W."9$G

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Trns/Exchange/Rollover	X01806_core_f	Cat.# 139737 (09/13)
	Page 5 of 6

9H1'64"+-%<'M"#-;#A'N",':<%#-'-+EO;>A'A"'5P=6H

(Important: This section must be witnessed by a Notary Public or Plan Administrator.)

PF,$4",7++.%$(+$,.+>"#,$4",!*+$#('$,%>"+$%&">,%+,:"'$%*+,X,%9,/(##%">,(+>,%9,(,B(#$%'%B(+$,%+,(+,P+$"#+(;,Q"R"+.",!*>",:"'$%*+, =IJ<0@,B;(+,64%'4,%9,9.0Z"'$,$*,AQP:7U,$4",7++.%$(+$89,9B*.9",%9,"+$%$;">,$*,0"+"&$9,.+>"#,$4%9,(##(+?"/"+$,%+,(''*#>(+'", 6%$4,$4",Q"$%#"/"+$,AW.%$2,7'$,*F,Xcl=,<iiQA788@G,f*#"*R"#U,QA7,#"W.%#"9,$4($,$4",9B*.9",'*+9"+$9,$*,(+2,>%#"'$,#*;;*R"#, $#(+9('$%*+G,7''*#>%+?;2U,*+",*F,$4",F*;;*6%+?U,(9,(BB;%'(0;"U,94*.;>,0",'*/B;"$">,(+>,6%$+"99">j

XG, PU,$4",+(/">,7++.%$(+$,*F,$4",!*+$#('$,%>"+$%&">,%+,:"'$%*+,XU,4"#"02,'"#$%F2,$4($,P,(/,-5O,/(##%">G

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YG, P,(/,$4",'.##"+$,9B*.9",*F,$4",(0*R"H+(/">,7++.%$(+$G,K2,(F&N%+?,/2,9%?+($.#",0";*6U,P,4"#"02,'*+9"+$,$*,$4%9,#"W."9$, F*#,(,>%#"'$,#*;;*R"#G,P,F.#$4"#,('E+*6;">?",(+>,F.;;2,.+>"#9$(+>,$4",'*+9"W."+'"9,*F,$4%9,'*+9"+$G,P,('E+*6;">?",(+>,

.+>"#9$(+>,$4($,P,4(R",$4",#%?4$,$*,#"'"%R",(,0"+"&$,F#*/,$4",!*+$#('$,%>"+$%&">,%+,:"'$%*+,X,64%'4,6(9,B.#'4(9">,.+>"#,(, :"'$%*+,=IJ<0@,(##(+?"/"+$U,(+>,$4($,P,4"#"02,6(%R",9.'4,#%?4$,6%$4,#"9B"'$,$*,$4",(/*.+$,0"%+?,>%#"'$;2,#*;;">,*R"#,F#*/, $4",!*+$#('$G

:%?+($.#",*F,3;(+,7++.%$(+$89,:B*.9",,

3#%+$,-(/",*F,7++.%$(+$89,:B*.9"

Notary Public/Plan Administrator

(Needs to be completed)

:$($",*F,

U,!*.+$2,*F,

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-*$(#2,3.0;%',r,:$(/B,s"#"

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9?1'524<"&;,G:<%#'H$28#8-A,%A",I-'H>J#"K<;$L;2;#A

For Direct Plan-to-Plan Transfers and Direct Rollovers only:

3>1?4%+#$,#@"/'%/#A'()",%/5B)24#C+'141-*/2*"/5"*D%/#2.*D"/1E%+#(%/-"4=

P,(/,$4",F*#/"#,A/B;*2"#)3;(+,7>/%+%9$#($*#)*$4"#,(.$4*#%L">,B"#9*+,*F,$4",%+>%R%>.(;,%>"+$%&">,%+,:"'$%*+,X,(+> ('E+*6;">?",$4($,$4%9,$#(+9('$%*+,%9,(BB#*R">,.+>"#,$4",A/B;*2"#89,=IJ<0@,B;(+G

:%?+($.#",*F,C*#/"#,A/B;*2"#)3;(+,7>/%+%9$#($*#)*$4"#,(.$4*#%L">,B"#9*+,,1($"

3#%+$,-(/",*F,C*#/"#,A/B;*2"#)3;(+,7>/%+%9$#($*#)*$4"#,(.$4*#%L">,B"#9*+,,3#%+$,O%$;"

:"B(#($%*+,F#*/,:"#R%'",1($"j,ppp)pppp)pppp,, _"9$%+?,ojpppppppppppppp

For all transactions other than a direct rollover to an IRA:

3>1?4%+#$,#F.//%4*#A'()",%/5B)24#C+'141-*/2*"/5"*D%/#2.*D"/1E%+#(%/-"4=

PF,$4%9,%9,(,=IJ<0@,'*+$#('$,"N'4(+?",.+>"#,$4",B;(+,*F,(+,A/B;*2"#U,+*,9B"'%&',A/B;*2"#,9%?+($.#",%9,#"W.%#">,%F,$4", A/B;*2"#,4(9,?%R"+,7V7,AW.%$(0;",>*'./"+$($%*+,(9,$*,(BB#*R">,B#*R%>"#9U,(+>,$4",$#(+9F"#"",B#*R%>"#,%9,%+';.>">,%+,9.'4, >*'./"+$($%*+G

P,(/,$4",'.##"+$,A/B;*2"#)3;(+,7>/%+%9$#($*#)*$4"#,(.$4*#%L">,B"#9*+,*F,$4",%+>%R%>.(;,%>"+$%&">,%+,:"'$%*+,X,(+>, ('E+*6;">?",$4($,$4%9,$#(+9('$%*+,%9,B"#/%$$">,.+>"#,$4",A/B;*2"#89,B;(+,(+>,$4($,P,(BB#*R",*F,$4%9,$#(+9('$%*+G

PF,$4%9,%9,(,=IJ<0@,'*+$#('$,"N'4(+?",.+>"#,$4",9(/",B;(+U,P,F.#$4"#,('E+*6;">?",$4($,$4",A/B;*2"#,(+>,$4",%99."#,*F,$4", $#(+9F"#""89,=IJ<0@,'*+$#('$,*#,=IJ<0@<S@,'.9$*>%(;,(''*.+$,(?#"",$*,"+$"#,%+$*,(+,%+F*#/($%*+,94(#%+?,(?#""/"+$,0"F*#", k(+.(#2,XU,YIIc,6%$4%+,$4",/"(+%+?,*F,O#"(9G,Q"?G,:"'G,=IJ<0@hXIG

:%?+($.#",*F,!.##"+$,A/B;*2"#)3;(+,7>/%+%9$#($*#)*$4"#,(.$4*#%L">,B"#9*+,,1($"

How to Edit Axa 1035 Exchange Online for Free

Only a few tasks can be easier than creating documents working with the PDF editor. There is not much for you to do to change the equitable 403b rollover form form - simply follow these steps in the following order:

Step 1: The first step should be to choose the orange "Get Form Now" button.

Step 2: After you've entered the equitable 403b rollover form edit page, you'll discover all actions you may use regarding your file in the upper menu.

The next parts are what you are going to prepare to have the finished PDF form.

Enter the appropriate information in Direct Transfer, TSA to TSA BHHBFFIJIJGKF, BBLBBB LBLMKG, Contract Exchange, TSA to TSA NFOPQR, IJIJSBGT LFBBOUVAWBR BBRBRFBFBR, Direct Rollover from TSA, Direct RolloverPQRIXJXUIYUIJBB, NFOBFNBUPQGO BBLBBBFFU LMKGPFFB, Destination of Funds Indicate, RMSA, and Rollover Conversion from TSA part.

The program will ask you to write certain essential details to instantly fill in the section Rollover Conversion from TSA, Rollover Conversion to Roth IRA, GOBBLBBB FFLMKGNoteTBWF FZG, TrnsExchangeRollover, Xcoref Page of, and Cat.

axa 1035 Rollover Conversion from TSA, Rollover Conversion to Roth IRA, GOBBLBBB FFLMKGNoteTBWF FZG, TrnsExchangeRollover, Xcoref Page of, and Cat blanks to fill out

The B Amount to be, Check One Box Only, Partial TransferExchange or, GBBFG PFBFPBPR BUBGPFBUBG, AXA Aggressive Allocation AXA, Target Allocation G Target, Asset Allocation, AXA Allocation Target, All Asset Aggressive Alt T All, Large Cap Stocks, EQGlobal MultiSector Equity, Invesco VI International Growth Z, MFS International Value A, AXA Tactical Manager M, and PIB EQAllianceBernstein Dynamic section will be the place to insert the rights and responsibilities of both sides.

Fill out the template by reading all these areas: AXA Allocation Target, All Asset Aggressive Alt T All, Strategies P, EQFranklin Templeton Allocation P, American Funds Insurance Series, Bond V, EQCore Bond Index EQGlobal Bond, EQIntermediate Government Bond TI, EQPIMCO Global Real Return Y, Bonds, Cash Equivalents, EQMoney Market T, GuaranteedFixed, Guaranteed Interest Option A, and International StocksGlobal.

Step 3: Choose the Done button to save your file. So now it is offered for upload to your gadget.

Step 4: Generate copies of the document - it can help you avoid future challenges. And don't worry - we are not meant to share or check the information you have.

3#%+$,-(/",*F,!.##"+$,A/B;*2"#)3;(+,7>/%+%9$#($*#)*$4"#,(.$4*#%L">,B"#9*+,,

3#%+$,O%$;"

Trns/Exchange/Rollover

X01806_core_f

Cat.# 139737 (09/13)

Page 6 of 6