Annuities account forms
Easily manage your annuity account with online self-service options and forms.
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All annuity forms
| Form | Description | Action |
|---|---|---|
| Set up automated withdrawals | Start, update, or terminate a Systematic Withdrawal or Required Minimum Distribution (RMD) program. | |
| Change your beneficiary | Change a beneficiary or update their information for your policy. | |
| Request an account change | Request a name change, update ownership, annuitant, or change your broker dealer, firm, or representative. | |
| Request a one-time withdrawal | Take a one-time withdrawal from your Prudential contract. *For 403(b) Tax Sheltered Annuity (TSA) contracts, please utilize the Annuity 403(b) form. | |
| Set up automated withdrawals for your FlexGuard Income account | Start, update, or terminate an automatic withdrawal for your FlexGuard Income Annuity. | |
| Adjust income tax withholdings | Update your tax withholdings for both state and federal taxes so that deductions from your annuity payments are accurate. | |
| Choose a payout for your beneficiary | Elect predetermined payout options for your beneficiaries, ensuring they receive any proceeds payable in the event of your passing according to your wishes. | |
| Elect maturity (annuitization) | Choose a form of payment as your contract approaches its Annuitization Date. | |
| Request a withdrawal from a claim | Request partial or full surrenders from annuity payout or interest payment option contracts. | |
| Reduce your 403(b) salary contributions | Start, modify, or cancel your contributions to your 403(b) plan. | |
| Request a 5-year deferral withdrawal | Request a full or partial withdrawal from your PruSecure Fixed Indexed Annuity. | |
| Convert your 403(b) tax-sheltered account | Change your 403(b) Tax-Sheltered Account to an Individual Retirement Account. | |
| Set up substantially equal periodic payments | Establish a schedule of periodic payments under 72(t) or 72(q). | |
| Change your payment date | Update the schedule of periodic payments under 72(t) or 72(q). | |
| Provide allocation instructions | Set up or update your investments in a 6 or 12-month Dollar Cost Averaging (DCA) program for Premier Retirement and Premier Advisor accounts. | |
| Add or remove withdrawal security restrictions | Add or remove a security restriction on your annuity contract before your withdrawal is processed. | |
| Authorize a custodian | Add, revoke, or change authorizations for a custodian to manage your Prudential Immediate Income Annuity. | |
| Authorize the owner | Add, revoke, or change authorizations for the owner of the account. | |
| Authorize the owner - Prudential Immediate Income annuity | Add, revoke, or change authorizations for the owner of a Prudential Immediate Income Annuity. | |
| Convert from a Traditional IRA to a Roth IRA | Convert your Traditional IRA to a Roth IRA. | |
| Release contract information | Authorize the release of information related to your annuity contract. | |
| Elect optional living benefits – custodial | Add optional living benefits to your annuity contract. | |
| Elect optional living benefits – NY | Add optional living benefits to your annuity contract (specific to New York residents). | |
| Certify your date of birth | Certify the date of birth of the annuitant. | |
| Certify your date of birth – Prudential Immediate Income Annuity | Certify the date of birth of the annuitant for Prudential Immediate Income Annuity. | |
| Change electronic fund transfer (EFT) | Add a bank account to your contract for future payments or update your bank account for a withdrawal. | |
| Enroll in electronic funds transfer (EFT) | Enroll in an electronic funds transfer (EFT). | |
| Enroll in electronic funds transfer – FlexGuard | Enroll in an electronic funds transfer (EFT) for FlexGuard accounts. | |
| Enroll in electronic funds transfer - FlexGuard Income | Enroll in an electronic funds transfer (EFT) for FlexGuard Income accounts. | |
| Exercise your right to cancel (Free Look) | Request to void an issued contract and get a refund or fund a new application. | |
| Continue payments | Request to establish or update benefit continuation information. | |
| Activate the Income Appreciator Benefit | Activate and set up payout for the Income Appreciator Benefit. | |
| Change trust beneficiary | Change ownership from a trust to trust beneficiary without tax implications. | |
| View Legacy Protection Plus portfolio | Learn more about Legacy Protection Plus by viewing the availability worksheet. | |
| Grant limited power of attorney – NY | Update authorizations for financial professionals (NY contracts only). | |
| Request a medically related surrender | Set up a surrender due to medical reasons. | |
| Request a medically related surrender - Prudential Defined Income | Set up a medical-related surrender for Prudential Defined Income. | |
| Request a medically related surrender - PruSecure Fixed Indexed | Set up a medical-related surrender for PruSecure Fixed Indexed. | |
| Claim non-custodial death benefits | Used by beneficiaries to elect a death claim payment after the owner's passing. | |
| Change marital status | Change an owner, beneficiary, or distribute funds due to divorce. | |
| Change marital status for Prudential Defined Income | Change an owner, beneficiary, or distribute funds due to divorce for Prudential Defined Income. | |
| Change marital status for Prudential Immediate Income | Change an owner, beneficiary, or distribute funds due to divorce for Prudential Immediate Income. | |
| Change marital status for PruSecure Fixed Indexed | Change an owner, beneficiary, or distribute funds due to divorce for PruSecure Fixed Indexed. | |
| Choose optional administrative programs | Set up optional investment programs. | |
| Choose optional benefit portfolio | Learn more about other optional benefits. | |
| Authorize owner and joint owner | Authorize Prudential to act on instructions from the owner or joint owner. | |
| Update payee and payment instructions | Update payee, payment instructions, or any tax withholding information. | |
| Submit a proof of life affidavit | Confirm annuitant information to ensure payments continue. | |
| Access Prudential Premier Retirement Variable portfolio | Learn more about Premier Retirement Variable portfolio options. | |
| Request the 90% Cap Rule Feature - Advanced Series | Elect the 90% Cap Rule Feature for Advanced Series. | |
| Request the 90% Cap Rule Feature - NY | Elect the 90% Cap Rule Feature for NY. | |
| Recharacterize your IRA | Recharacterize a Roth IRA to a Traditional IRA. | |
| Set up Prusecure Fixed Indexed payments | Establish a schedule of periodic payments under IRC Section 72(t) or 72(q). | |
| Set up substantially equal periodic payments | Establish a schedule of periodic payments under IRC Section 72(t) or 72(q). | |
| Change your payment date | Change the payment date after age 72. | |
| Self-certify for late rollover contribution | Certify a late rollover contribution. | |
| Provide subsequent payment allocation instructions | Update allocation for subsequent payments. | |
| Authorize a trust | Update or confirm the acting trustee(s) of a trust-owned account. | |
| Request a 403(b) withdrawal | Request full or partial withdrawals from a 403(b) tax-sheltered account. |
Don’t see what you need?
How to access your forms
- Log in to your account.
- In the Quick Actions, click Product Summary.
- Scroll to Quick Links and select See Annuity Forms.
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How to complete online
- Log in to your account.
- In the Quick Actions, click Change Beneficiaries.
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How to complete online
- Log in to your account.
- In the Quick Actions, click Withdrawal.
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