Full Cash Surrender Request Form Instructions
This file contains the Full Cash Surrender Request Form from OneAmerica. It provides necessary instructions and information for policyholders looking to request a surrender of their cash value. This document is essential for ensuring a smooth and compliant surrender process.
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How do I fill this out?
To fill out this form, start by providing your personal details including the policy number and your contact information. Next, select the appropriate options regarding your cash surrender request and choose your tax withholding preferences. Finally, ensure all required signatures are obtained before submitting the form.

How to fill out the Full Cash Surrender Request Form Instructions?
1
Complete the top section with your personal and policy information.
2
Select your options for cash surrender and tax withholding.
3
Sign the form where indicated and, if applicable, obtain your spouse's signature.
4
Review the completed form for accuracy and completeness.
5
Submit the form to the specified address for processing.
Who needs the Full Cash Surrender Request Form Instructions?
1
Policyholders looking to access their cash value for personal needs.
2
Individuals transitioning into retirement who need cash for expenses.
3
Those undergoing financial hardship requiring immediate funds.
4
Beneficiaries of a deceased policyholder who need to liquidate assets.
5
Investors wanting to reallocate funds from their life insurance policies.
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What are the instructions for submitting this form?
To submit this form, mail it directly to the address provided on the form. Additionally, you may have the option to fax your completed documents to the insurance company. If available, online submission may also be pursued through the company’s website for efficiency.
What are the important dates for this form in 2024 and 2025?
Important dates for 2024 include deadlines for tax submissions which can affect your cash surrender value. Likewise, keep an eye on any changes in insurance regulations that may take effect in 2025. Always consult with your insurance agent to verify specific transaction timelines.

What is the purpose of this form?
The purpose of the Full Cash Surrender Request Form is to initiate the process for a policyholder to access cash value accumulated in their permanent life insurance policy. This form ensures that all required information is systematically collected to facilitate the insurance company in processing the request correctly. Additionally, it serves as a legal document to confirm that the policyholder understands the implications of surrendering their policy.

Tell me about this form and its components and fields line-by-line.

- 1. Policy Number: The unique identifier for the insurance policy.
- 2. Insured/Annuitant: The person covered by the insurance policy.
- 3. Owner: The individual to whom the policy belongs.
- 4. Tax Withholding Elections: Selections regarding any federal or state tax withholding.
- 5. Signatures: Space for signatures required for processing the surrender.
What happens if I fail to submit this form?
If the form is not submitted correctly, it will delay your cash surrender request and may result in financial losses. Additionally, any missing information will prevent processing and require the submission of a new form. It is crucial to ensure all required fields and sections are completely filled out to avoid such issues.
- Processing Delays: Failure to complete the form correctly will slow down your surrender request.
- Financial Loss: Inaccuracy may lead to loss of benefits or funds.
- Legal Complications: Not adhering to requirements can cause legal disputes regarding policy ownership.
How do I know when to use this form?

- 1. Cash Withdrawal Request: To obtain the cash value from permanent life insurance.
- 2. Tax Planning: When managing tax responsibilities associated with gains.
- 3. Policy Changes: If you're altering your insurance coverage needs.
Frequently Asked Questions
What is the purpose of the Full Cash Surrender Form?
The form is used to request the surrender of cash value from a life insurance policy.
How do I submit the completed form?
You can submit the form by mailing it to the provided address or using our online submission features.
Can I edit this PDF file in PrintFriendly?
Yes, PrintFriendly allows you to edit your PDFs easily before downloading.
What information do I need to fill out this form?
You will need your policy number, personal information, and any relevant tax withholding preferences.
Is there a tax implication with full cash surrender?
Yes, surrendering your policy can produce taxable gains which need to be considered.
Can I save the edited PDF directly on PrintFriendly?
You can download your edited PDF after making changes, but direct saving is not currently available.
What happens if I lose my policy document?
You should indicate on the form that you have searched for it but cannot locate it.
Are there any fees associated with the cash surrender?
Yes, withdrawal charges and premiums may apply when processing your surrender request.
Who can help me fill out the form if I encounter issues?
Customer service representatives from your insurance company can assist with filling it out.
What if I need assistance with tax implications?
Consulting with a tax advisor is recommended for questions regarding tax implications of cash surrender.
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