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PUERTO RICO
Life Products
Life Products
NWL Lifetime Returns Select® (ICC19 01-1189-19)
Form Description Required Forms
DM-1069 NWL Lifetime Returns Select Consumer Brochure
DM-1069s LTRS Consumer Brochure - Spanish Version
DM-1070 NWL Lifetime Returns Select Target Premiums
DM-1071 Not Required NWL Lifetime Returns Select Folder
DM-1094 Trust Information Form
DM-1177 State Approval Chart - Life
DM-1248 LTRS Highlight Sheet
DM-1285 Knock-Out Questions
ICC14 01-9063-14 (REV.2018A) Application for Life
ICC14 01-S028 Equity Index Life Application Supplement
ICC18 01-S043-18 Disclosure for Terminal Illness ABR - Compact
ICC19 01-S057-19 Disclosure for Chronic Illness ABR - Compact
OP-2344 Existing Coverage Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
SA-5900 Comparative Information Form
SA-5905-PR Notice to Policy Holder for PR
SA-8505 Social Security Verification (W-9)
SU-6592 Authorization for Release of Health Related Information
Annuities
Annuities
NWL IMPACT 10® (01-1162-10)
Form Description Required Forms
01-S026PR-16(Rev.2018) Annuity Withdrawal Benefit Rider App Supp - PR
DM-1058 Not Required Income Outlook Highlights.
DM-1094 Trust Information Form
DM-1122 Not Required Income Outlook Plus 5 - Highlights
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1178 State Approval Chart - Annuity
DM-1181 NWL Impact 10 Disclosure Brochure
DM-1184 Not Required Impact 10 Highlight Sheet
DM-1195 Not Required Income Outlook Plus 5 - WBR Chart 7%
DM-1196 Not Required Income Outlook - WBR Chart 7%
DM-1203 Income Outlook Plus 5 Disclosure Brochure
DM-1204-PR Income Outlook Disclosure Brochure - PR
DM-1234 Suitability FAQs
DM-1265 New Business Cover Sheet
DM-1475 Not Required Traditional IRA Disclosure Statement Supplement
DM-1476 Not Required Roth IRA Disclosure Statement Supplement
DM-1512 RegEd Product Specific Training Instructions
ICC14 01-9046-14 [REV.2018A] Application for Annuity
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
SA-8505 Social Security Verification (W-9)
SA-8714 Minimum Distribution Requirements Disclosure
NWL IMPACT 7® (01-1160-10)
Form Description Required Forms
01-S026PR-16(Rev.2018) Annuity Withdrawal Benefit Rider App Supp - PR
DM-1058 Not Required Income Outlook Highlights.
DM-1094 Trust Information Form
DM-1122 Not Required Income Outlook Plus 5 - Highlights
DM-1123 Not Required Income Outlook Plus 5 - WBR Chart 5%
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1178 State Approval Chart - Annuity
DM-1180 NWL Impact 7 Disclosure Brochure
DM-1185 Not Required Impact 7 Highlight Sheet
DM-1203 Income Outlook Plus 5 Disclosure Brochure
DM-1204-PR Income Outlook Disclosure Brochure - PR
DM-1234 Suitability FAQs
DM-1265 New Business Cover Sheet
DM-1475 Not Required Traditional IRA Disclosure Statement Supplement
DM-1476 Not Required Roth IRA Disclosure Statement Supplement
DM-1512 RegEd Product Specific Training Instructions
ICC14 01-9046-14 [REV.2018A] Application for Annuity
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
SA-8505 Social Security Verification (W-9)
SA-8714 Minimum Distribution Requirements Disclosure
NWL Ultra Future®-PR (01-1170-14)
Form Description Required Forms
01-S026PR-16(Rev.2018) Annuity Withdrawal Benefit Rider App Supp - PR
DM-1051-PR Not Required Income Outlook WBR Chart - PR
DM-1058 Income Outlook Highlights.
DM-1094 Trust Information Form
DM-1108 Ultra Future Consumer Disclosure Brochure
DM-1122 Income Outlook Plus 5 - Highlights
DM-1125-PR Not Required Income Outlook Plus5 - WBR Chart - PR
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1178 State Approval Chart - Annuity
DM-1203 Income Outlook Plus 5 Disclosure Brochure
DM-1204-PR Income Outlook Disclosure Brochure - PR
DM-1265 New Business Cover Sheet
DM-1475 Not Required Traditional IRA Disclosure Statement Supplement
DM-1476 Not Required Roth IRA Disclosure Statement Supplement
DM-1512 RegEd Product Specific Training Instructions
ICC14 01-9046-14 [REV.2018A] Application for Annuity
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
SA-8505 Social Security Verification (W-9)
SA-8714 Minimum Distribution Requirements Disclosure
SA-9925 NWL® Ultra Future Annuity Highlights
NWL® Core Dynamic (ICC17 01-1178-17)
Form Description Required Forms
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 NWL Core Dynamic Consumer Disclosure Brochure
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-1512 RegEd Product Specific Training Instructions
ICC14 01-9046-14 [REV.2018A] Application for Annuity
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
SA-5905-PR Notice to Policy Holder for PR
SA-8505 Social Security Verification (W-9)
SA-8714 Minimum Distribution Requirements Disclosure
NWL® Ultra Value (01-1141-06)
Form Description Required Forms
01-S026PR-16(Rev.2018) Annuity Withdrawal Benefit Rider App Supp - PR
DM-1023 Not Required Ultra Value Highlight Sheet
DM-1052 Not Required NWL Withdrawal Benefit Rider Income Outlook Chart - 2%
DM-1058 Not Required Income Outlook Highlights.
DM-1094 Trust Information Form
DM-1110 NWL Ultra Value Consumer Disclosure Brochure
DM-1122 Not Required Income Outlook Plus 5 - Highlights
DM-1124 Not Required Income Outlook Plus 5 - WBR Chart 2%
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1203 Income Outlook Plus 5 Disclosure Brochure
DM-1204-PR Income Outlook Disclosure Brochure - PR
DM-1234 Suitability FAQs
DM-1265 New Business Cover Sheet
DM-1475 Not Required Traditional IRA Disclosure Statement Supplement
DM-1476 Not Required Roth IRA Disclosure Statement Supplement
DM-1512 RegEd Product Specific Training Instructions
ICC14 01-9046-14 [REV.2018A] Application for Annuity
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
SA-8505 Social Security Verification (W-9)
SA-8714 Minimum Distribution Requirements Disclosure
NWL Ultra Classic® (01-1135-04)
Form Description Required Forms
01-S026PR-16(Rev.2018) Annuity Withdrawal Benefit Rider App Supp - PR
DM-1050 Not Required NWL Withdrawal Benefit Rider Income Outlook Chart
DM-1058 Not Required Income Outlook Highlights.
DM-1094 Trust Information Form
DM-1122 Not Required Income Outlook Plus 5 - Highlights
DM-1126 Not Required Income Outlook Plus 5 - WBR Chart No Bonus
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1178 State Approval Chart - Annuity
DM-1203 Income Outlook Plus 5 Disclosure Brochure
DM-1204-PR Income Outlook Disclosure Brochure - PR
DM-1234 Suitability FAQs
DM-1265 New Business Cover Sheet
DM-1475 Not Required Traditional IRA Disclosure Statement Supplement
DM-1476 Not Required Roth IRA Disclosure Statement Supplement
DM-1512 RegEd Product Specific Training Instructions
ICC14 01-9046-14 [REV.2018A] Application for Annuity
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
SA-8505 Social Security Verification (W-9)
SA-8714 Minimum Distribution Requirements Disclosure
SA-9924 Not Required Ultra Classic Highlight Sheet
SA-9930 Ultra Classic Consumer Disclosure Brochure
NWL Protector One® (01-1129-11)
Form Description Required Forms
DM-1094 Trust Information Form
DM-1174 Annuity Suitability Questionnaire for all Applicants
DM-1214 Protector One Disclosure Brochure
DM-1215 Not Required Protector One Highlights Sheet
DM-1234 Suitability FAQs
DM-1265 New Business Cover Sheet
DM-1475 Not Required Traditional IRA Disclosure Statement Supplement
DM-1476 Not Required Roth IRA Disclosure Statement Supplement
ICC14 01-9046-14 [REV.2018A] Application for Annuity
OP-2101-NB Preventing Annuity NIGO Tips
OP-2343 Suitability Replacement Chart Supplement
OP-2406 1035 Exchange/Rollover/Transfer Form
SA-8505 Social Security Verification (W-9)
SA-8714 Minimum Distribution Requirements Disclosure
Single Premium Immediate Annuity(SPIA) (01-1011)
Form Description Required Forms
01-9021 SPIA Application
DM-1094 Trust Information Form
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-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
SA-8505 Social Security Verification (W-9)
SA-8512 Not Required SPIA Consumer Information Guide
SA-8629 SPIA Quote Form
SA-8699 SPIA Disclosure
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-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
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 Annuity Surrender Request
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
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
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
SU-6412 Authorization To Obtain and Disclose Information