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CALIFORNIA
Foreign National Program
Foreign National
Life Products
Life Products
NWL Lifetime Returns Select® (ICC19 01-1189-19)
Form Description Required Forms
01-9063CA-15(REV.01-23) Application for Individual Life Ins - CA
01-S028(Rev.3/14) EQUITY INDEX LIFE APPLICATION SUPPLEMENT
01-S041 Third Party Notice Request Form
DM-1069 NWL Lifetime Returns Select Consumer Brochure
DM-1069s LTRS Consumer Brochure - Spanish Version
DM-1070 Not Required NWL Lifetime Returns Select Target Premiums
DM-1071 Not Required NWL Lifetime Returns Select Folder
DM-1094 Trust Information Form
DM-1164-CA Internal Replacement Life and Annuities - CA
DM-1177 State Approval Chart - Life
DM-1248 Not Required LTRS Highlight Sheet
DM-1285-CA Knock-Out Questions - California
OP-2344 Existing Coverage Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
OP-2515-CCLTRS CA Checklist-Lifetime Returns Select
SA-8446-CA Replacement of Life Insurance or Annuities for CA
SA-8505 Social Security Verification (W-9)
SA-8717 Policy Life Illus Agent Certification & App Ack
SA-9252-CA Notice to CA Residents Age 65 & Older
SP-8207 Not Required Authorization for Automatic Bank Draft
SP-8280-CA NWL California Privacy Policy
SU-6412-CA Authorization To Obtain & Disclosure Information for CA
SU-6592 Authorization for Release of Health Related Information
SU-6611 Replacement List
NWL® Lifetime Returns Solutions (ICC19 01-1189-19)
Form Description Required Forms
01-9062-10 SPIA Application
01-9063CA-15(REV.01-23) Application for Individual Life Ins - CA
01-S028(Rev.3/14) EQUITY INDEX LIFE APPLICATION SUPPLEMENT
01-S041 Third Party Notice Request Form
DM-1094 Trust Information Form
DM-1146 Lifetime Returns Solutions Consumer Brochure
DM-1147 Not Required Lifetime Returns Solutions Min / Max Premiums
DM-1148 Not Required Lifetime Returns Solutions Highlights
DM-1149 Not Required Lifetime Returns Solutions Procedures
DM-1153 NWL Lifetime Returns Solutions SPIA Disclosure
DM-1164-CA Internal Replacement Life and Annuities - CA
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1177 State Approval Chart - Life
DM-1268 LTRS Information Sheet
DM-1285-CA Knock-Out Questions - California
DM-1512 RegEd Product Specific Training Instructions
OP-2343 Suitability Replacement Chart Supplement
OP-2344 Existing Coverage Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
OP-2514-CCLTRS CA Checklist-Lifetime Returns Solutions
SA-8446-CA Replacement of Life Insurance or Annuities for CA
SA-8505 Social Security Verification (W-9)
SA-8717 Policy Life Illus Agent Certification & App Ack
SA-9252-CA Notice to CA Residents Age 65 & Older
SP-8280-CA NWL California Privacy Policy
SU-6412-CA Authorization To Obtain & Disclosure Information for CA
SU-6592 Authorization for Release of Health Related Information
W-4P Withholding Information for Pension or Annuity Payments
Annuities
Annuities
NWL® Core Dynamic (ICC17 01-1178-17)
Form Description Required Forms
01-9046CA-14 Application for Annuity - CA
BG-ANN-13 Buyers Guide to Annuities
DM-1094 Not Required Trust Information Form
DM-1164-CA Internal Replacement Life and Annuities - CA
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1234 Suitability FAQs
DM-1265 New Business Cover Sheet
DM-1342 Not Required NWL Core Dynamic Roth IRA Disclosure Statement
DM-1343 Not Required NWL Core Dynamic IRA Disclosure Statement
DM-1350 Not Required NWL Core Dynamic Highlight Sheet
DM-1351-CA NWL Core Dynamic Consumer Brochure - CA
DM-1475 Not Required Traditional IRA Disclosure Statement Supplement
DM-1476 Not Required Roth IRA Disclosure Statement Supplement
DM-1510 Producer Disclosure for Annuities
DM-1512 RegEd Product Specific Training Instructions
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
OP-2513-CCCD CA Checklist - Core Dynamic
SA-8446-CA Replacement of Life Insurance or Annuities for CA
SA-8505 Social Security Verification (W-9)
SA-8714 Minimum Distribution Requirements Disclosure
SA-9252-CA Notice to CA Residents Age 65 & Older
SP-8280-CA NWL California Privacy Policy
SU-6412-CA Authorization To Obtain & Disclosure Information for CA
SU-6611 Replacement List
NWL® Impact (01-1161-16-CA)
Form Description Required Forms
01-9046CA-14 Application for Annuity - CA
01-S026-16(Rev.2018) Annuity Withdrawal Benefit Rider App Supp -Generic
BG-ANN-13 Buyers Guide to Annuities
DM-1094 Not Required Trust Information Form
DM-1164-CA Internal Replacement Life and Annuities - CA
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1234 Suitability FAQs
DM-1265 New Business Cover Sheet
DM-1337 Income Outlook NH WBR Consumer Brochure
DM-1395 NWL Impact Roth IRA Disclosure Statement
DM-1396 NWL Impact IRA Disclosure Statement
DM-1398-CA Impact Consumer Disclosure Brochure - CA
DM-1402 NWL Impact Highlights
DM-1422 NWL Income Outlook NH Highlights
DM-1475 Not Required Traditional IRA Disclosure Statement Supplement
DM-1476 Not Required Roth IRA Disclosure Statement Supplement
DM-1510 Producer Disclosure for Annuities
DM-1512 RegEd Product Specific Training Instructions
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
OP-2512-CCIPT CA Checklist - Impact
SA-8446-CA Replacement of Life Insurance or Annuities for CA
SA-8505 Social Security Verification (W-9)
SA-8714 Minimum Distribution Requirements Disclosure
SA-9252-CA Notice to CA Residents Age 65 & Older
SP-8280-CA NWL California Privacy Policy
SU-6412-CA Authorization To Obtain & Disclosure Information for CA
SU-6611 Replacement List
NWL® Pro Dynamic (01-1180-17-CA)
Form Description Required Forms
01-9046CA-14 Application for Annuity - CA
BG-ANN-13 Buyers Guide to Annuities
DM-1094 Trust Information Form
DM-1164-CA Internal Replacement Life and Annuities - CA
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1234 Suitability FAQs
DM-1265 New Business Cover Sheet
DM-1341-VAR Not Required NWL Pro Dynamic Var. Highlight Sheet
DM-1344-VAR Not Required NWL Pro Dynamic IRA Disc. Statement-Variation
DM-1345-VAR Not Required NWL Pro Dynamic Roth IRA Disc. Statement-Variation
DM-1346-CA NWL Pro Dynamic Consumer Disclosure Brochure - CA
DM-1353 NWL Dynamic Series State Approval Chart
DM-1475 Not Required Traditional IRA Disclosure Statement Supplement
DM-1476 Not Required Roth IRA Disclosure Statement Supplement
DM-1510 Producer Disclosure for Annuities
DM-1512 RegEd Product Specific Training Instructions
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
OP-2511-CCPD CA Checklist - Pro Dynamic
SA-8446-CA Replacement of Life Insurance or Annuities for CA
SA-8505 Social Security Verification (W-9)
SA-8714 Minimum Distribution Requirements Disclosure
SA-9252-CA Notice to CA Residents Age 65 & Older
SP-8280-CA NWL California Privacy Policy
SU-6412-CA Authorization To Obtain & Disclosure Information for CA
SU-6611 Replacement List
NWL® Ultra Value (01-1141-06)
Form Description Required Forms
01-9046CA-14 Application for Annuity - CA
01-S026-15 Annuity Withdrawal Benefit Rider Application Suppl
BG-ANN-13 Buyers Guide to Annuities
DM-1017 Not Required NWL® Ultra Value IRA Disclosure Statement
DM-1018 Not Required NWL® Ultra Value Roth IRA Disclosure Statement
DM-1023 Not Required Ultra Value Highlight Sheet
DM-1052 Not Required NWL Withdrawal Benefit Rider Income Outlook Chart - 2%
DM-1094 Trust Information Form
DM-1110-CA NWL Ultra Value Consumer Disclosure Brochure CA
DM-1122 Income Outlook Plus 5 - Highlights
DM-1124 Not Required Income Outlook Plus 5 - WBR Chart 2%
DM-1164-CA Internal Replacement Life and Annuities - CA
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1178 State Approval Chart - Annuity
DM-1203 Income Outlook Plus 5 Disclosure Brochure
DM-1234 Suitability FAQs
DM-1265 New Business Cover Sheet
DM-1337 Income Outlook NH WBR Consumer Brochure
DM-1422 NWL Income Outlook NH Highlights
DM-1475 Not Required Traditional IRA Disclosure Statement Supplement
DM-1476 Not Required Roth IRA Disclosure Statement Supplement
DM-1510 Producer Disclosure for Annuities
DM-1512 RegEd Product Specific Training Instructions
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
OP-2507-CCUV NWL Ultra Value California Application Checklist
SA-8446-CA Replacement of Life Insurance or Annuities for CA
SA-8505 Social Security Verification (W-9)
SA-8714 Minimum Distribution Requirements Disclosure
SA-9252-CA Notice to CA Residents Age 65 & Older
SP-8280-CA NWL California Privacy Policy
SU-6412-CA Authorization To Obtain & Disclosure Information for CA
SU-6611 Replacement List
NWL Ultra Classic® (01-1135-04)
Form Description Required Forms
01-9046CA-14 Application for Annuity - CA
01-S026-15 Not Required Annuity Withdrawal Benefit Rider Application Suppl
BG-ANN-13 Buyers Guide to Annuities
DM-1050 Not Required NWL Withdrawal Benefit Rider Income Outlook Chart
DM-1094 Trust Information Form
DM-1122 Income Outlook Plus 5 - Highlights
DM-1126 Not Required Income Outlook Plus 5 - WBR Chart No Bonus
DM-1164-CA Internal Replacement Life and Annuities - CA
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1178 State Approval Chart - Annuity
DM-1203 Income Outlook Plus 5 Disclosure Brochure
DM-1234 Suitability FAQs
DM-1265 New Business Cover Sheet
DM-1337 Income Outlook NH WBR Consumer Brochure
DM-1422 NWL Income Outlook NH Highlights
DM-1475 Not Required Traditional IRA Disclosure Statement Supplement
DM-1476 Not Required Roth IRA Disclosure Statement Supplement
DM-1510 Producer Disclosure for Annuities
DM-1512 RegEd Product Specific Training Instructions
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
OP-2509-CCUC CA Checklist - Ultra Classic
SA-8446-CA Replacement of Life Insurance or Annuities for CA
SA-8505 Social Security Verification (W-9)
SA-8714 Minimum Distribution Requirements Disclosure
SA-9252-CA Notice to CA Residents Age 65 & Older
SA-9924 Not Required Ultra Classic Highlight Sheet
SA-9930-CA NWL Ultra Classic Consumer Disclosure Brochure CA
SA-9940 Not Required NWL® Ultra Classic IRA Disclosure Statement
SA-9942 Not Required NWL® Ultra Classic Roth IRA Disclosure Statement
SP-8280-CA NWL California Privacy Policy
SU-6412-CA Authorization To Obtain & Disclosure Information for CA
SU-6611 Replacement List
NWL Ultra Future® (01-1137-04)
Form Description Required Forms
01-9046CA-14 Application for Annuity - CA
01-S026-16(Rev.2018) Annuity Withdrawal Benefit Rider App Supp -Generic
BG-ANN-13 Buyers Guide to Annuities
DM-1051 Not Required NWL Withdrawal Benefit Rider- Income Outlook Chart 9%
DM-1094 Trust Information Form
DM-1108-CA NWL Ultra Future Consumer Disclosure Brochure CA
DM-1122 Income Outlook Plus 5 - Highlights
DM-1125 Not Required Income Outlook Plus 5 - WBR Chart 9%
DM-1164-CA Internal Replacement Life and Annuities - CA
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1178 State Approval Chart - Annuity
DM-1203 Income Outlook Plus 5 Disclosure Brochure
DM-1234 Suitability FAQs
DM-1265 New Business Cover Sheet
DM-1337 Income Outlook NH WBR Consumer Brochure
DM-1422 NWL Income Outlook NH Highlights
DM-1475 Not Required Traditional IRA Disclosure Statement Supplement
DM-1476 Not Required Roth IRA Disclosure Statement Supplement
DM-1510 Producer Disclosure for Annuities
DM-1512 RegEd Product Specific Training Instructions
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
OP-2508-CCUF CA Checklist - Ultra Future
SA-8446-CA Replacement of Life Insurance or Annuities for CA
SA-8505 Social Security Verification (W-9)
SA-8714 Minimum Distribution Requirements Disclosure
SA-9252-CA Not Required Notice to CA Residents Age 65 & Older
SA-9925 Not Required NWL® Ultra Future Annuity Highlights
SA-9946 Not Required NWL® Ultra Future IRA Disclosure Statement
SA-9947 Not Required NWL® Ultra Future Roth IRA Disclosure Statement
SP-8280-CA NWL California Privacy Policy
SU-6412-CA Authorization To Obtain & Disclosure Information for CA
SU-6611 Replacement List
Single Premium Immediate Annuity(SPIA) (01-1011)
Form Description Required Forms
01-9021 SPIA Application
DM-1094 Trust Information Form
DM-1097 Not Required NWL SPIA ROTH IRA DISCLOSURE STATEMENT
DM-1098 Not Required NWL SPIA IRA DISCLOSURE STATEMENT
DM-1117 Not Required NWL SPIA Annuity Highlights
DM-1164-CA Internal Replacement Life and Annuities - CA
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1178 State Approval Chart - Annuity
DM-1234 Suitability FAQs
DM-1265 New Business Cover Sheet
DM-1510 Producer Disclosure for Annuities
DM-1512 RegEd Product Specific Training Instructions
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
OP-2510-CCSPIA CA Checklist - SPIA
SA-8446-CA Replacement of Life Insurance or Annuities for CA
SA-8505 Social Security Verification (W-9)
SA-8512 Not Required SPIA Consumer Information Guide
SA-8629 SPIA Quote Form
SA-8699 SPIA Disclosure
SA-9252-CA Notice to CA Residents Age 65 & Older
SP-8280-CA NWL California Privacy Policy
SU-6412-CA Authorization To Obtain & Disclosure Information for CA
SU-6611 Replacement List
W-4P Withholding Information for Pension or Annuity Payments
Financial Information Forms
Financial Information Forms
Financial Information Forms
Form Description Required Forms
SA-9112 Financial Highlights Page
Policyowner Service Forms
Policyowner Service Forms
Policyowner Service Forms
Form Description Required Forms
ACA-1018 Request for Systematic Withdrawal of Interest
DM-1266 AIEN Authorization
DM-1331 Qualified Charitable Distr-IRA One-Time Withdrawal
DM-1410 Additional Beneficiary Designations
OP-2202-GEN Annuity Claimant Statement - Annuitized Contracts
OP-2220 Withdrawal Benefit Rider Restart Request Form
PB-1001 Claimant Statement Annuity Death Claim
PB-1002 Life Claimant Statement
PB-1011 Claim to Waive Annuity Withdrawal Charge
PB-1020-MA Required Disclosure Statement for Living Benefit Rider (Accelerated Benefits)
SA-8136 Payroll Deduction Transmittal
SA-8505 Social Security Verification (W-9)
SA-8538 IRA Disclosure Statement for Policy 01-1073
SA-8714 Minimum Distribution Requirements Disclosure
SA-9059-A Annuity Policy/Certificate Delivery Receipt
SA-9059-L Life Policy Delivery Receipt
SA-9698 Early Distribution Solutions
SA-9699 Early Distribution Transfer Request
SAT-1792 Policyholder Online Account Access
SP-7064 Assignment of Policy as Collateral
SP-7116 Life Policy Loan Agreement
SP-7117 PolicyOwner Service Request
SP-7120 Policyowners Endorsement of Policy
SP-7161 Change Of Beneficiary
SP-7241 Request for Change in Policy
SP-7356-CA Annuity Surrender Form - California
SP-7360 Policy Loan Agreement
SP-7378 Authorization for List Bill
SP-7389 Request for Installment Certificate
SP-8123 Policyowner Change Request
SP-8130 L.E.R.O. Settlement Request
SP-8165 Election Of Distribution Method
SP-8207 Authorization for Automatic Bank Draft
SP-8213 Request for Direct Deposit of Payments (Multiple Payments Only)
SP-8215 Annuity Partial Surrender Request
SP-8239 Non-Qualified Loan Agreement
SP-8244 Security Agreement
SP-8257 Request For Systematic Payment of the Penalty-Free Withdrawal
SP-8261 Life Surrender Request
SP-8262 Life Partial Surrender Request
SP-8270 Explanation of Direct Rollover Option for Governmental 457 Plans
SP-8282 Request for Systematic Payment of the Required Minimum Distribution
SP-8285 Heirship Affidavit/ Ownership Change Request
SP-8303 Equity Index Universal Life Interest Election/Transfer Request
SP-8318 Request for Systematic Payment Under the WBR
SP-8326 Your Rollover Options
SP-8327 Hardship Withdrawal Request and Certification
SP-8339 Annuity Address Change Request
SP-8511-CA California Resident Request to Know/Delete/Correct
SU-6412-CA Authorization To Obtain & Disclosure Information for CA
W-4P Withholding Information for Pension or Annuity Payments
W-4R Withholding Certificate
Standard Company Forms
Standard Company Forms
Standard Company Forms
Form Description Required Forms
01-S015 Sports & Avocation General Questionnaire
5305-SEP Simplified Employee Pension - Individual Retirement Accounts Contribution IRS Form
DM-1094 Trust Information Form
DM-1429 Wholesaler Map
DM-1530 Inherited Account Information Form
OP-2406 1035 Exchange/Rollover/Transfer Form
PPS-1107 Qualified Plans Information Sheet
SA-2000 Request for Wire Transfer of Funds
SA-8608 Disclosure Statement
SA-8762 Notice of Revised Illustration
SA-8786 EFT (Electronic Fund Transfer)
SA-8801 Life Insurance Illustration Regulations
SA-9059-L Life Policy Delivery Receipt
SA-9165 Fixed Indexed Annuity Issue Procedures
SA-9698 Early Distribution Solutions
SA-9699 Early Distribution Transfer Request
SA-9988 Cross Border Sales
SP-7378 Authorization for List Bill
SP-8280-CA NWL California Privacy Policy