AMERITAS (ACACIA) FORMS
1035(a) Exchange of Life Insurance and Annuity Policy - UN 1117 NY [NY]
1035(a) Exchange of Life Insurance and Annuity Policy - UN 1117 [Generic]
403(b) Acacia Information Sharing Agreement - AG 5225 Acacia
403(b) Ameritas Information Sharing Agreement - AG 5225 ALIC
403(b) Employer-Plan Administrator Transfer Authorization - UN 1155
About Qualified Plans
Acacia Application for Single Premium Immediate Annuity-SPIA - FXAN
Additional Requirements/Forms
Advisor Select VA Application - GenVA MA-OR-PA [MA-OR-PA]
Advisor Select VA Application - GenVA [Generic]
Allocation Change Form - Medley/Accent/Acclaim/Annuity II/III and III/P - AG 5222
Annuity Fee Authorization - PS 235
Anti-Money Laundering Policies and Procedures - UN 1051 [Generic]
Anti-Money Laundering Requirements - UN 1052 [Generic]
Application Booklet Cover Sheet - PF 378
Assignment as Collateral Security - MD 539
Authorization Agreement to Release Policy Information - PS 231
Client Disclosure Booklet - AIC 472 [Generic]
Client Disclosure Receipt and Acknowledgement - AIC 569
Customer Identification Program Notice - AG 3899LL
Definition of Replacement - UN 2174-1 NY [NY]
Disclosure for 5 Percent Roll-Up GMDB Rider - AG 5208 [PA]
Disclosure for Greater of Step-Up or 5 Percent Roll-Up GMDB Rider - AG 5209 [PA]
Disclosure for Periodic Step-Up GMDB Rider - AG 5207 [PA]
Disclosure Notice for Applicants 65 and Older - UN 3171 [CA]
Disclosure NY Annuity to Annuity - UN 2174-3 NY [NY]
Disclosure Statement - UN 2174-2 KS [KS]
Disclosure Statement - UN 2174-2 NY [NY]
Disclosure Statement Part C Annuity to Annuity - UN 2174-3A NY [NY]
EFT Authorization Agreement for Pre-Arranged Deposits - Annuity Only - EFT
Electronic Funds Transfer - UN 2178 [Generic]
Expense-Disbursement Allocation - Medley/Accent/Acclaim/Annuity II/III and II/P - AG 5223
Fax Application Cover Sheet - MD 2274 [Generic]
Fixed Annuity - Internal & External Replacement Form - UN 1441-A [Generic]
Fixed Annuity Suitability Questionnaire - AF 1201
Fixed SPIA Acacia Disclosure - AG 5239 [Generic]
Foreign National Notice and Acknowledgement - UN 0918 [Generic]
GLWB Disclosure Statement - AG 5215 [PA]
GLWB Rider Withdrawal Phase Election Request - Ameritas - AG 5226
Guaranty Notice to be Provided to Client at Time of Application - 1683 MN [MN]
Individual Life and Annuity PIN Authorization Agreement - PS 3000 T [Generic]
Instructions for Application
Instructions for Systematic Programs
Internal-External Replacement Form - Fixed Deferred Annuity - UN 1441 NV [NV]
Letter of Understanding for SIMPLE IRA Plans - AG 4602
Limited Power of Attorney Appointment Form - MD 126
Medley Variable Annuity Booklet - AG 3234 (6-08) [CA-MD-MN-MT]
Medley Variable Annuity Booklet - AG 3234 (9-08) [Generic]
Medley Variable Annuity Booklet - AG 3234 FL [FL]
Medley Variable Annuity Booklet - AG 3234 MA [MA]
Medley Variable Annuity Booklet - AG 3234 NJ OR TX [NJ-OR-TX]
Medley Variable Annuity Booklet - AG 3234 PA [PA]
Medley Variable Annuity Booklet - AG 3234 VA [VA]
Model Asset Allocation and Investment Advisory Agreement - UN 3899
Morningstar Asset Allocation Program ADV - MSTAR ADV
New Account Form (AIC Reps Only) - AIC 12 [Generic]
Notice Regarding Standards for Medi-Cal Eligibility for Applicants Age 65 and Older - UN 3220 [CA]
Online Registration Instructions - PF 471
Optional Investment Strategies - Medley/Accent/Acclaim/Annuity II/III and III/P - AG 5220
Privacy Protection Statement - PRIVACY [Generic]
Qualified Retirement Plan Information Statement - PA 200
Replacement Form - External - UN 2174 KS [KS]
Replacement Form - Fixed Annuity - UN 2174 NV ANN [NV]
Replacement Form - Internal - UN 2174-1 KS [KS]
Replacement Form - UN 2174 AR [AR]
Replacement Form - UN 2174 CA [CA]
Replacement Form - UN 2174 DE [DE]
Replacement Form - UN 2174 FL [FL]
Replacement Form - UN 2174 GA [GA]
Replacement Form - UN 2174 ID [ID]
Replacement Form - UN 2174 IL [IL]
Replacement Form - UN 2174 IN [IN]
Replacement Form - UN 2174 MA [MA]
Replacement Form - UN 2174 MN [MN]
Replacement Form - UN 2174 MO [MO]
Replacement Form - UN 2174 OK [OK]
Replacement Form - UN 2174 PA [PA]
Replacement Form - UN 2174 SD [SD]
Replacement Form - UN 2174 TN [TN]
Replacement Form - UN 2174 WA [WA]
Replacement Form - UN 2174 WY [WY]
Replacement Form - UN 2174-2 AR [AR]
Replacement Form - UN 2174-2 [Generic]
Replacement Form for Regulation 60 NY - UN 2174 NY [NY]
Request for Information and Authorization - UN 2174-4 NY [NY]
Salary Reduction Agreement - UI 340
Savings Incentive Match Plan for Employees Agreement - AA 5304 SIMPLE
SEP IRA Contribution Agreement - AA 5305 SEP
SPIA Disclosure for Annuitants 75 with Non-Refund Payout - AG 4174
Systematic Programs - PF 424
Telephone Authorization - PS 2312 [Generic]
Temporary Receipt - F0634
Third Party Transfer Authorization - PS 2313 [Generic]
Transfer-Rollover Request Form - PA 163
Transfer-Rollover Request Form - PA 163 NY [NY]
Variable Annuity Application - NLVA [Generic]
Variable Annuity Application - NLVA-FL [FL]
Variable Annuity Application - NLVA-OR [OR]
Variable Annuity Application - NLVA-PA [PA]
Variable Annuity Disclosure Form - AIC 638 AAS
Variable Annuity Disclosure Form - AIC 638 NVLA
