New York Form 20885 PDF Details

In navigating the intricacies of life insurance and annuity policies, the New York 20885 form emerges as a critical document for managing how these policies interact with trust arrangements. Specifically designed by the New York Life Insurance Company, this form serves a vital purpose for trusts that are neither created by wills (testamentary trusts) nor operate in the same legal framework. Its primary use is for establishing or altering life and annuity policies either at the inception of a policy (new business) or during its term (inforce changes). Detailing everything from the insured and policy numbers to the specifics of the trust—such as its name, establishment date, and the trustees involved—it ensures that the policy aligns with the directives and beneficiaries designated within the trust. Completeness and accuracy in filling out the preliminary sections and securing necessary signatures are paramount, underscoring the form’s role in confirming the trust's authority and the terms under which policy proceeds are handled. With provisions for both life insurance policies and annuity contracts, it outlines the procedures for benefit disbursement and affirms the rights of policy ownership, even if the trust is irrevocable. Amidst these specifications, New York Life reserves the right to request additional documentation from the trust, reinforcing the importance of transparency and validation in these financial arrangements. Additionally, the form addresses compliance needs such as taxpayer identification and backup withholding certifications, key to fulfilling IRS requirements. Overall, the New York 20885 form embodies a comprehensive approach to integrating trust arrangements with life insurance and annuity policies, facilitating a smoother management process for policyholders and trustees alike.

QuestionAnswer
Form NameNew York Form 20885
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesget the new york life form 20885, new york mv93 form, new york life forms, lottery trust forms new york

Form Preview Example

NEW YORK LIFE INSURANCE COMPANY

NEW YORK LIFE INSURANCE AND ANNUITY CORPORATION (A Delaware Corporation)

NYLIFE INSURANCE COMPANY OF ARIZONA (Not licensed in every state)

STATEMENT OF TRUST - (For Trusts other than Testamentary Trusts)

Instructions:

•Use this form for Life and Annuity policies (new business and inforce changes).

•Do not use this form for a Testamentary Trust (a trust created within a will).

•Items 1-10 on page one must be completed in full.

•Complete page three and secure required signatures.

•For inforce policies, the Change of Beneficiary form (21131) and Transfer of Ownership form for life policies (21132) can be found in the Transfer of Ownership Life Kit (form 22600). The Transfer of Ownership form for annuity policies can be found in the Transfer of Ownership Annuity Kit (form 22599).

•Agent Certification section on page three must be completed and signed by agent - if your agent is assisting you with this change. If completing this form without an agent and the owner is a trust, please provide a copy of the trust agreement.

•In all instances New York Life reserves the right to request a copy of the trust if we deem it necessary.

Complete items 1-10 before proceeding

1.PROPOSED INSURED(s)/INSURED(s)/ANNUITANT(s)

2.POLICY NUMBER(s)

3. I/We affirm that the Trust Agreement created by

as Grantor/

SettLOr/Trustor is in effect and contains the following information:

4.Trust Name:

5.Trust Date:

6.State where Trust Established

7.Beneficiary(ies) of Trust:

8.Relationship of Trust Beneficiary(ies) to Proposed Insured(s)/Insured(s)/Annuitant(s):

9. Name(s) of Trustee(s):

Note: If more than one Trustee, we require all Trustees to sign applicable forms, unless we receive a copy of the Trust stating that the Trustees can act independently.

10.Relationship of Trustee(s) to

Proposed Insured(s)/Insured(s)/Annuitant(s):

 

 

RETURN FORM TO:

 

 

 

 

 

 

 

For Variable Life and Variable Annuity policies:

New York Life, Variable Products Service Center

 

 

 

Madison Square Station, PO Box 922, New York, NY 10159

 

For all other policies:

If You Live In: AL, CT, DC, DE, FL, GA, IL, IN, KY, MA, ME, MD, MI, MS, NC, NH, NJ, NY, OH, PA, RI, SC, TN, VA, VT, WI, or WV, return this form to:

New York Life, Cleveland Service Center

PO Box 6916, Cleveland, OH 44101

If You Live In: AK, AR, AZ, CA, CO, HI, IA, ID, KS, LA, MN, MO, MT, NE, ND, NM, NV, OK, OR, SD, TX, UT, WA, or WY, return this form to:

New York Life, Dallas Service Center

PO Box 130539, Dallas, TX 75313-0539

Other: (i.e. foreign address, etc) return form to either location above.

20885 (1/10) Page 1 of 3

Please read this page and secure required signatures on page three.

STATEMENT REGARDING TRUST AS POLICY BENEFICIARY

I/We affirm that the beneficiary designation for each policy listed agrees with a Trust Agreement created by the Grantor and dated as shown on page one.

For Life Insurance Policies:

If, before the proceeds are paid, the Insurer(s) receives proof that the Trust as policy beneficiary is not in effect at the Insured’s death, the proceeds shall be paid to the contingent beneficiary(ies), if any. Otherwise, the proceeds shall be paid in a single sum to the Owner, if the Owner is living at that time. If the Owner is not living at that time, the single sum shall be paid to the Owner’s Estate.

For Annuity Contracts:

Please see your Agent/Registered Representative for payment methods available upon death of the Owner/Annuitant.

For Life Insurance Policies and Annuity Contracts:

Before the Insurer(s) pays the proceeds at death, it may ask for proof that the Trust is in effect;

The Owner possesses all rights of ownership of each policy including the right to change the beneficiary designation at any time even if there is a contrary provision in the Trust Agreement. This applies to revocable and irrevocable trusts; The Insurer(s) will not have any liability after it pays the proceeds of each policy, as set forth in this Statement;

The Interest of the Trust(s) in each of these policies shall be subject to any assignment of that policy made before or after this Statement.

STATEMENT REGARDING TRUST AS OWNER

I/We affirm that the Trust Agreement created by the Grantor as shown on page one (and the trust date as shown on page one) agrees with the following:

1.The Trustee(s) have full authority to pay premiums.

2.The Trust Agreement contains no limitations on the ownership rights of the Trust(s) as owner(s) of the insurance/annuity policies.

20885 (1/10) Page 2 of 3

IMPORTANT: The Internal Revenue Service (IRS) requires that the named Owner complete the following:

(The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding).

Taxpayer Identification Number and Backup Withholding Certifications

Policyowner’s Taxpayer Identification Number is

Under penalties of perjury, I certify that the number shown above is my correct Taxpayer Identification Number. I further certify that I am a U.S. person (including a U.S. resident alien).

I also certify that (please check only one box):

I have been notified by the IRS that I am subject to backup withholding.

I am not subject to backup withholding because (a) I have not been notified that I am subject to backup withholding as a result of failure to report all interest or dividends, or (b) the IRS has notified me that I am no longer subject to backup withholding.

/

/

 

X

 

X

 

Date

 

 

Grantor(s) signature

 

Grantor(s) signature, if required

 

/

/

 

X

 

X

 

 

 

 

 

 

 

 

Date

 

 

Trustee(s) signature

 

Trustee(s) signature, if required

 

/

/

 

X

 

X

 

Date

 

 

Proposed Insured(s)/Insured(s)/Annuitant(s) signature

 

Additional Signature, if required

 

/

/

 

X

 

X

 

Date

 

 

Applicant(s)/Owner(s) signature, if other than above

 

Additional Signature, if required

 

\

\

If the indicated policy is corporate-owned, provide signatures and titles of two corporate officers below.

Print Name & Title of OfficerPrint Name & Title of Officer

/

/

 

X

 

X

Date

 

 

Officer’s Signature

 

Officer’s Signature

AGENT CERTIFICATION

(if Agent assists with completion of form)

By signing below I attest that I have reviewed the identifying trust document(s) described on page one and that the document(s) appeared to be genuine and original.

Print Name of Agent/Registered Representative

X

/

/

Agent/Registered Representative’s Signature

 

Date

 

20885 (1/10) Page 3 of 3

How to Edit New York Form 20885 Online for Free

In case you want to fill out new york life forms, you don't need to download any kind of software - simply use our PDF editor. The tool is constantly updated by our team, acquiring powerful features and growing to be greater. Here's what you would have to do to start:

Step 1: Access the PDF form in our editor by hitting the "Get Form Button" in the top part of this page.

Step 2: With our state-of-the-art PDF tool, you can actually accomplish more than merely complete blanks. Edit away and make your forms look great with custom textual content incorporated, or modify the original content to excellence - all that comes with the capability to insert your personal pictures and sign the PDF off.

It is actually an easy task to finish the form with our detailed guide! This is what you should do:

1. You have to fill out the new york life forms properly, therefore be attentive when working with the parts comprising these blank fields:

A way to fill in new york life statement of trust form portion 1

2. Given that the previous part is finished, you're ready add the needed particulars in Taxpayer Identification Number and, Policyowners Taxpayer, Under penalties of perjury I, I also certify that please check, I have been notified by the IRS, I am not subject to backup, Date, Date, Date, Date, X Grantors signature, Trustees signature, Grantors signature if required, Trustees signature if required, and X Proposed so you're able to progress to the third part.

Completing part 2 of new york life statement of trust form

Concerning Taxpayer Identification Number and and Grantors signature if required, be certain that you take a second look in this section. Those two are thought to be the key ones in the page.

3. Within this part, check out Print Name Title of Officer, Date, X Officers Signature, Print Name Title of Officer, Officers Signature, AGENT CERTIFICATION, if Agent assists with completion, By signing below I attest that I, Print Name of AgentRegistered, X AgentRegistered Representatives, Date, and Page of. Each of these must be filled out with greatest focus on detail.

Step number 3 for submitting new york life statement of trust form

Step 3: Before finalizing this form, check that blanks have been filled in properly. Once you verify that it's fine, click “Done." Acquire the new york life forms after you sign up at FormsPal for a free trial. Instantly get access to the pdf form in your FormsPal account, together with any modifications and adjustments conveniently saved! When using FormsPal, you can fill out documents without worrying about personal data leaks or entries getting shared. Our protected platform helps to ensure that your personal data is kept safe.

New York Form 20885 isn’t the one you’re looking for?

Related Documents