Engaging with the Nationwide Withdrawal form is a critical step many annuity owners may consider on their journey towards financial planning for retirement. This document meticulously outlines options for those looking into accessing funds before the culmination of their contract, ensuring policyholders are well informed about the implications of such decisions. It's vital to acknowledge that while annuities aim to be robust pillars for retirement savings, situations arise where accessing these funds becomes necessary. The form delves into the nuances of making partial or total withdrawals, highlighting potential charges and tax implications that might affect the contract's value and the policyholder's financial health. Emphasizing long-term financial strategies, it offers guidance on alternative routes to income without fully surrendering one's annuity, suggesting penalty-free withdrawals based on specific contract features, or converting the annuity into a guaranteed income stream, thereby safeguarding one's investment from rash decisions. Furthermore, the Nationwide Withdrawal form stands as a reminder of the annuity's benefits, such as tax-deferred growth and guaranteed death benefits—key considerations that underscore the importance of thoughtful deliberation before making withdrawal decisions. Notably, the document also serves as a prompt for contract owners to discuss their plans with investment professionals, ensuring that any action taken aligns with their broader financial goals and complies with the intricate rules governing annuity contracts.
| Question | Answer |
|---|---|
| Form Name | Nationwide Form Withdrawal |
| Form Length | 5 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min 15 sec |
| Other names | nationwide form withdrawal, nationwide form contract withdrawal, withdrawal nationwide annuity form, nationwide contract owner withdrawal form |
Take a
As you know, your annuity is designed to help you invest for retirement. And there are ways it can ofer you income without completely surrendering your contract.
If you’re considering replacing your Nationwide® annuity with another
Moving to another annuity provider often brings with it a new surrender charge period that would begin all over again, potentially locking up your money for seven years or more
Don’t forget all the good things your Nationwide annuity brings you, lik e a guaranteed death benefit for your family that isn’t subject to market downturns or interest rate changes
If you’re concerned about the volatility of your annuity’s current investment op tions, you can transfer among many other underlying investment options within your
You can let your annuity continue to grow tax deferred for y our
If you need access to your money now, consider these options:
Take income from other investments you may have that don’t carry surrender charge s, fees or adverse tax consequences
You may also have
If your need is longer term, turn your annuity into a guaranteed stream of income by an nuitizing your contract (ask your investment professional for more details)
Of course, there are always rules.
We want to make sure you know what they are. Please keep these things in mind:
A withdrawal will be subject to ordinary income taxes and, if you’re not yet 59½ years old, a 10% federal income tax penalty may also apply
Withdrawals can reduce the features that come with your annuity, like your death benefi t or optional riders
Depending on when you bought your annuity and how long it’s been since you made a purc hase payment, contingent deferred sales charges (CDSC) may also apply to withdrawals or surrenders
Consult with your investment professional today for the options that may be right for you. And feel free to contact us with any questions. We’re available Monday through Friday from 8 a.m. to 8 p.m. Eastern time by calling
All guarantees and protections, where available, are subject to the
Annuities and life insurance are issued by Nationwide Life Insurance Company or Nationwide Life and Annuity Insurance Company, Columbus, Ohio. The general distributor for variable products is Nationwide Investment Services Corporation, member FINRA. In MI only: Nationwide Investment Svcs. Corporation.
Nationwide, the Nationwide framemark and On Your Side are service marks of Nationwide Mutual Insurance Company.
©
This page left blank intentionally.
Contract Owner Withdrawal Form
Mail to: Nationwide Financial®*, Individual Annuities, PO Box 182021, Columbus, Ohio,
Fax to:
1. General Information |
Please print. |
1a. Owner Information
Existing Contract Number
(Required)
Contract Owner First/Last Name
Telephone
Number
()
2.Type of Withdrawal (Please check only one.)
Partial Withdrawal: |
|
Important Note for |
|||
! |
|||||
your contract was issued as part of a partial 1035 exchange |
|||||
Amount |
$ |
|
|||
|
after June 30, 2008, and a distribution or surrender is made |
||||
|
|
|
|||
|
|
|
|
from either contract within 12 months after the exchange, |
|
Amount after taxes and charges |
|
||||
|
all or a portion of the amount transferred from the original |
||||
Amount before taxes and charges (Default) |
|
||||
|
contract may be treated as a taxable distribution, subject |
||||
Total Withdrawal |
|
to both income taxation and the 10% early distribution |
|||
|
penalty, unless, the distribution or surrender meets certain |
||||
|
|
|
|
||
Hardship Withdrawal (401 and 403(b) only) |
|
deined exceptions. Please consult your prospectus for more |
|||
Penalty Free/Age Base Withdrawal (Calculated by Nationwide) |
information and discuss any tax consequences concerning |
||||
any contemplated transactions with a professional tax advisor. |
|||||
3.Method of Payment (Please check only one.)
Direct Deposit (A voided check or a letter from your inancial institution is required. Deposit slips, starter checks, money market, or brokerage accounts are not acceptable.)
Check to Contract Owner
Check to Alternate Payee** (Please ill out the following ields.)
Check payable to/Name
Address
City/State/ZIP
Overnight: If carrier name and billing number are not included, a $25 fee is required for this service. The fee will be taken from the contract proceeds and classiied as a taxable event. This option excludes transfers and withdrawals taken during the “Right to Examine and Cancel” period, processed as
Carrier Name and Billing#:
4.Tax Withholding (Please check only one.)
! |
If this section is |
|
Do not withhold taxes |
|
Withhold federal taxes |
|
% |
|
|
Withhold state taxes |
% |
blank, we will |
|
|
|
|
|
||||||
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
||
|
default to |
For state withholding, please list your state of residence: |
|
|
|
|
|
||||
|
withholding |
|
|
|
|
|
|||||
taxes.
Note: If state income tax is withheld, as required by speciic states and their regulations, Nationwide will round the dollar amount up to the next whole dollar.
5. Taxpayer ID Certiication
I certify that under penalties of perjury that: 1) The Taxpayer Identiication Number or Social Security Number listed on this form is my correct taxpayer identiication number. 2) I am not subject to backup withholding because:
(a)I have not been notiied that I am subject to backup withholding as a result of a failure to report all interest or dividends, or
(b)The Internal Revenue Service has notiied me that I am no longer subject to backup withholding, or that I am exempt from backup withholding, and
3) I am a U.S. person (including a U.S. resident alien)
You must cross out item (2) if you have been notiied by the IRS that you are currently subject to backup withholding because of failure to report interest or dividends on your tax return.
The Internal Revenue Service does not require your consent to any provision of this document other than the certiications required to avoid backup withholding.
*Nationwide Financial annuities are issued by Nationwide Life Insurance Company and Nationwide Life and Annuity Insurance Company.
* V A F - 0 1 6 8 A O . 1 3 . P 1 * 03/2011 |
Contract Owner Withdrawal Form
Page 2 of 3
6.Disclosure and General Information
•A voided check or letter from your bank/inancial institution must be included for the direct deposit option. If no voided check or letter from your inancial institution is included a check will be mailed to the contract owner’s address of record. The deposit to your
checking or savings account will normally occur two (2) business days after the date of the withdrawal from the annuity contract. Please note that deposit slips are not acceptable
•You may be liable for federal and state income tax on the taxable amount of the withdrawal. These may include both federal and state income taxes, underestimated tax withholding penalty, and 10% early withdrawal penalty if under 59 1/2 (including withdraw-
als under Capital Preservation Plus Lifetime Income (CPPLI) Option or the Nationwide Lifetime Income Rider (L.Inc) Option)
•For Qualiied Plans (401(a), 401(k), 403(b), etc., Nationwide may be required to withhold 20%. A 20% mandatory withholding will occur for all taxable distributions eligible to be rolled into an IRA or other Qualiied Plan that are not done as a “direct rollover or trustee to trustee transfer. Distributions made from a Qualiied Plan to a
•For all other taxable distributions (including from a
•If you elected an Extra Value Option in your existing annuity, the credited amount may be recaptured in accordance with the terms of the Extra Value Option
•Contracts with CPPLI or L.Inc: Additional withdrawals over your allowable annual amount will reduce your current beneit base and
may reduce the annual lifetime income withdrawals in future years
•Withdrawals in excess of the guaranteed withdrawal amount, called “excess withdrawals”, may result in a permanent reduction in future guaranteed withdrawal amounts. Please refer to your product prospectus for additional information. If you would like to make an excess withdrawal and are uncertain how an excess withdrawal will reduce your future withdrawal amounts, you may contact Nationwide prior to requesting the withdrawal to obtain a personalized,
It is hereby expressly represented that no person, irm, or corporation other than the undersigned has any interest in this contract, and that no proceedings in insolvency or bankruptcy have been instituted or are pending against the undersigned.
If this withdrawal is from a tax sheltered or tax deferred program, the undersigned expressly represents a personal knowledge of applicable program restrictions and hereby acknowledges that this speciic withdrawal transaction is in conformity with and is not prohibited by the terms of that program. Nationwide makes no warranties regarding the tax consequences of this transaction. Please consult your tax advisors for details.
* V A F - 0 1 6 8 A O . 1 3 . P 2 * 03/2011 |
Contract Owner Withdrawal Form
Page 3 of 3
6. Disclosure and General Information (Continued.)
IMPORTANT - Additional Charges May Apply - Please acknowledge the following:
I understand that charges, fees, and beneit losses may apply to any withdrawal, 1035 Exchange, Trustee to Trustee Transfer, or Direct
Rollover I request. I also understand that as of ____/_____/______, I will forfeit charges totaling approximately $, which
includes one or more of the following charges: Contingent Deferred Sales Charges, Excess Withdrawal Charges and /or Extra Value beneits forfeited. In addition, I understand that any market value adjustment may be deducted from my distributions as outlined in
the prospectus. (Initials) |
STOP |
|
To obtain these current charges or potential lost beneits, or to learn about options available to you, please contact our Service Center at
7.Signature (Must complete signatures and provide Social Security Number (SSN) or Tax ID Number (TIN).) I certify that all of the information I have provided in this form is accurate and true.
Contract Owner/Custodian Name:
Contract Owner/Custodian Signature:
Joint Owner Name: (If applicable.)
Joint Owner Signature:
X
X
SSN or TIN:
Date:
Date:
Want a transaction status? Provide an
**Please note: If the gross amount of your withdrawal request is greater than or equal to $50,000 and you choose to have your withdrawal made out to a third party or have your withdrawal sent to an address other than your address of re- cord, or a bank account other than your own bank account, you must have your signature guaranteed by a participating Medallion STAMP (Securities Transfer Agents Medallion Program) program member. A Medallion STAMP signature guarantee is an authentication of a signature in the form of a stamp or seal by a bank, a stock exchange member or another acceptable guarantor. A notary’s stamp or seal is not a Medallion STAMP; therefore a notarized signature will not be accepted. You can obtain a Medallion STAMP signature guarantee from a commercial bank, savings bank, credit union, or broker dealer authorized to provide Medallion STAMP signature guarantees. Medallion STAMP signature guarantees will not be accepted by fax.
! Important
Medallion Stamp/Signature Guarantee:
(Required As Described**)
If any information contained on this form is unclear or incomplete, Nationwide will correspond directly with the contract owner via regular mail.
* V A F - 0 1 6 8 A O . 1 3 . P 3 * 03/2011 |