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ING USA ANNUITY AND LIFE INS CO FORMS


1035 Transfer-Exchange Form - Fixed - 130191
1035 Transfer-Exchange Form - Variable Annuities - 129615
72(t) and 72(q) Fact Finder Form - 130995
72(T) And 72(Q) Request - 129949
72(t)-72(q) Request - Fixed Annuity Contracts - 130909
Abuse Notification - 130663 [NM]
Acknowledgement Form - 136873 [NC]
Agent Appointment Request - 129581
Agent Data Form - 129581
Agreement for Required Minimum Distribution Option - RMD - for Fixed Annuities - 130897
Annuity Suitability Questionnaire - 154894 [FL]
Assembly Bill 2107 Disclosure - 127663 [CA]
Authorization Agreement For Compensation Direct Deposit - 133854
Authorization for Release of Health-Related Info - 128274 [NY]
Beneficiary Account Information Sheet - 150444
Beneficiary Designation Request - 140265
Beneficiary Designation with Restricted Payout - 130977
Benefit Summary and Discl for 403(b)-Roth 403(b)-IRA and Non-Qualified
Buyers Guide to Annuities - 102777 [NH]
Buyers Guide to Annuities - 124960 [GA]
Buyers Guide to Annuities - 124961 [WI]
Buyers Guide to Annuities - 124962 [NM]
Buyers Guide to Annuities - 124984 [SC]
Buyers Guide to Annuities - 125006 [Generic]
Buyers Guide to Annuities - 147510 [KY]
Certificate of Trust - 148002
Classic Choice Disclosure - 134443 [NY]
Classic Flex Disclosure - 134313 [NY]
Comparative Information Statement - 148874 [NV]
Confidential Abuse Information Notification - 129793 [NM]
Customer Identification Worksheet - 130967
Direct Deposit Authorization - 130541
Disclosure and Comparison of Annuity Contracts - 154895 [FL]
Disclosure for Single Premium Products - 130629 [KS]
Elderly Notice - 129815 [CA]
Elective Annuity Payment Option - Fixed Annuity - 130588
Elective Annuity Payment Option - Variable Annuity - 145081
Electronic Funds Transfer (EFT) Authorization - 130633
Envoy Nine Annuity Disclosure - 145031 [Generic]
Envoy Nine Annuity Disclosure - 146166 [VT]
Envoy Nine Annuity Disclosure - 146369 [MN]
Envoy Nine Annuity Disclosure - 146561 [CT]
Envoy Nine Annuity Disclosure - 146564 [AK]
Envoy Nine Annuity Disclosure - 146567 [DE-UT-WA]
Envoy Nine Annuity Disclosure - 146855 [ND]
Envoy Nine Annuity Disclosure - 147074 [MO]
Envoy Nine Annuity Disclosure - 147572 [PA]
Envoy Nine Annuity Disclosure - 149830 [FL]
Envoy Nine Annuity Disclosure - 149946 [NJ]
Envoy Nine Annuity Disclosure - 151018 [OR]
Envoy Nine Annuity Preliminary Contract Summary - 152722 [WI]
Envoy Six Annuity Disclosure - 145030 [Generic]
Envoy Six Annuity Disclosure - 146165 [VT]
Envoy Six Annuity Disclosure - 146368 [MN]
Envoy Six Annuity Disclosure - 146560 [CT]
Envoy Six Annuity Disclosure - 146563 [AK]
Envoy Six Annuity Disclosure - 146566 [DE-UT-WA]
Envoy Six Annuity Disclosure - 146854 [ND]
Envoy Six Annuity Disclosure - 147073 [MO]
Envoy Six Annuity Disclosure - 147571 [PA]
Envoy Six Annuity Disclosure - 149829 [NJ]
Envoy Six Annuity Disclosure - 149945 [FL]
Envoy Six Annuity Disclosure - 151017 [OR]
Envoy Six Annuity Prelimnary Contract Summary - 152721 [WI]
Envoy Three Annuity Disclosure - 145028 [Generic]
Envoy Three Annuity Disclosure - 146163 [VT]
Envoy Three Annuity Disclosure - 146366 [MN]
Envoy Three Annuity Disclosure - 146559 [CT]
Envoy Three Annuity Disclosure - 146562 [AK]
Envoy Three Annuity Disclosure - 146565 [DE-UT-WA]
Envoy Three Annuity Disclosure - 146853 [ND]
Envoy Three Annuity Disclosure - 147071 [MO]
Envoy Three Annuity Disclosure - 147569 [PA]
Envoy Three Annuity Disclosure - 149828 [FL]
Envoy Three Annuity Disclosure - 149943 [NJ]
Envoy Three Annuity Disclosure - 151015 [OR]
Envoy Three Annuity Preliminary Contract Summary - 152720 [WI]
Financial Service Request - 133304
Fixed and Indexed Annuity App - 133926 [CT]
Fixed and Indexed Annuity App - 134011 [Generic]
Fixed and Indexed Annuity App - 134551 [SD]
Fixed and Indexed Annuity App - 136095 [MA]
Fixed and Indexed Annuity App - 136311 [NC]
Fixed and Indexed Annuity App - 140475 [UT]
Fixed and Indexed Annuity App - 141779 [FL]
Fixed and Indexed Annuity App - 142834 [NJ]
Fixed Annuities Instructions - 130727
Fixed Annuity Needs Analysis - 132848
Fixed Annuity Needs Analysis - 149167
Goldenselect - Beneficiary Designation Restricted Payout - 129804
Goldenselect - Income Plan (Annuitization) Request - 129578
Guarantee Choice Annuity Disclosure - 139512 [Generic]
Guarantee Choice Annuity Disclosure - 139861 [PA]
Guarantee Choice Annuity Disclosure - 139918 [FL]
Guarantee Choice Annuity Disclosure - 141151 [MN-WA]
Guarantee Choice Annuity Disclosure - 141179 [IN]
Guarantee Choice Annuity Disclosure - 145140 [OR]
Guarantee Choice Annuity Preliminary Contract Summary - 152728 [WI]
IncomeProtector Disclosure - 150536 [PA]
IncomeProtector Secure Five Disclosure - 150537 [CT]
IncomeProtector Secure Outlook Disclosure - 150544 [CT]
IncomeProtector Secure Seven Disclosure - 150538 [CT]
IncomeProtector Selectra Disclosure - 150545 [CT]
IncomeProtector SimpleChoice Seven Disclosure - 150539 [CT]
IncomeProtector Withdrawal Benefit Disclosure - 141907 [FL]
IncomeProtector Withdrawal Benefit Disclosure - 142983 [PA]
IncomeProtector Withdrawal Benefit Disclosure - 150535 [Generic]
ING Envoy IncomeProtector Withdrawal Benefit Disclosure - 150543 [CT]
ING Focus VA Transfer-1035 Exchange Request - 129295
ING GoldenSelect Deferred Variable Annuity Application - 151279 [Generic]
ING GoldenSelect Deferred Variable Annuity Application - 151280 [NC]
ING GoldenSelect Deferred Variable Annuity Application - 151281 [TX]
ING GoldenSelect Deferred Variable Annuity Application - 153502 [MN]
ING IncomeProtector Withdrawal Benefit (v2) Rider Specimen - 150546
ING Joint IncomeProtector Withdrawal Benefit (v2) Rider Specimen - 151061
ING LifePay Plus / Joint LifePay Plus Election - 148920
ING Rollover Choice Request for Financial Service - 147563
ING SimpleChoice Seven Bank Application - 142982 [Generic]
ING SimpleChoice Seven Bank Application - 143153 [NC]
ING SimpleChoice Seven Bank Application - 143154 [CT]
ING SimpleChoice Seven Bank Application - 143155 [FL]
ING SimpleChoice Seven Bank Application - 143439 [NJ]
ING SimpleChoice Seven Bank Application - 144791 [MA]
ING SimpleChoice Seven Bank Application - 147923 [SD]
ING SimpleChoice Seven Bank Application - 147941 [UT]
Internal Replacement Disclosure - 135820
Life Only Disclaimer - 130599
Living Benefit Allocation Election - 139563
Loan Application and Promissory Note - 130357
Nexus Worksheet
Non-Natural Owner Certification Exemption Form - 130991
Notice Concerning Policyholders Rights in an Insolvency - 150650 [MN]
Option Package Transfer - 146145
Policy Holder Rights Notice - 129786 [MN]
Preliminary Contract Summary - 129792 [WI]
Producer Change Request - 129586
Proposed Sale - Only When Customer Requests - FL
Reg Rep Assistant Telephone Authorization - 130025
Replacement Notice (External) - 130622 [PA]
Replacement Notice (Internal) - 130623 [PA]
Replacement Notice - 130600 [KS]
Replacement Notice - 130601 [DE]
Replacement Notice - 130602 [FL]
Replacement Notice - 130603 [IL]
Replacement Notice - 130604 [IN]
Replacement Notice - 130606 [ID-IL]
Replacement Notice - 130607 [TN]
Replacement Notice - 130608 [CA]
Replacement Notice - 130609 [MA]
Replacement Notice - 130610 [MO]
Replacement Notice - 130611 [NV]
Replacement Notice - 130612 [OK]
Replacement Notice - 130613 [OK]
Replacement Notice - 130617 [SD]
Replacement Notice - 130618 [GA-KS]
Replacement Notice - 130619 [GA]
Replacement Notice - 130620 [WY]
Replacement Notice - 130621 [WA]
Replacement Notice - 130624 [MN]
Replacement Notice - 130708 [Multi-State]
Replacement Regulation Procedures Form - 154186 [Multi-State]
Replacement Regulations - 140473 [Multi-State]
Replacement Regulations - 154963 [AR]
Request for Financial Service - 148355
Request for Financial Service for VA - 147561
Request for Financial Service for VA - ING DVA - 154484
Request for ING Income Optimizer - 153190
Request for ING Income Optimizer - Rollover Choice - 153277
Request for Loan and Promissory Note - Variable TSA Contracts Only - 129683
Request for Minimum Distribution - 129612
Request For Non-Financial Service - 129700
Required Minimum Distribution - RMD - Request - 124769
Retirement Solutions Transfer - 129589
Secure Five Disclosure - 139266 [Generic]
Secure Five Disclosure - 139267 [IN-VT]
Secure Five Disclosure - 139268 [ND]
Secure Five Disclosure - 139883 [MN]
Secure Five Disclosure - 140018 [PA]
Secure Five Disclosure - 140931 [IL]
Secure Five Disclosure - 147624 [WA]
Secure Five Disclosure - 149038 [AR]
Secure Index Five Annuity Preliminary Contract Summary - 152725 [WI]
Secure Index Opportunities Plus Preliminary Contract Summary - 152723 [WI]
Secure Index Seven Annuity Preliminary Contract Summary - 152724 [WI]
Secure Opportunities Plus Disclosure - 141685 [Generic]
Secure Opportunities Plus Disclosure - 142225 [AR]
Secure Opportunities Plus Disclosure - 142243 [ND]
Secure Opportunities Plus Disclosure - 142571 [IN-VT]
Secure Opportunities Plus Disclosure - 142660 [IL]
Secure Opportunities Plus Disclosure - 143437 [UT]
Secure Opportunities Plus Disclosure - 145082 [PA]
Secure Opportunities Plus Disclosure - 148603 [FL]
Secure Outlook Disclosure - 140761 [CT]
Secure Outlook Disclosure - 140908 [Generic]
Secure Outlook Disclosure - 140934 [NJ]
Secure Outlook Disclosure - 141723 [PA]
Secure Outlook Disclosure - 142226 [MN]
Secure Seven Disclosure - 136263 [NJ]
Secure Seven Disclosure - 138935 [Generic]
Secure Seven Disclosure - 138936 [AR-IN-VT]
Secure Seven Disclosure - 138938 [ND]
Secure Seven Disclosure - 139392 [CT]
Secure Seven Disclosure - 139624 [MN]
Secure Seven Disclosure - 139652 [PA]
Secure Seven Disclosure - 142008 [IL]
Secure Seven Disclosure - 142240 [AK-DE-NJ-UT]
Secure Seven Disclosure - 145668 [WA]
Secure Seven Disclosure - 149037 [FL]
Smartdesign - Beneficiary Designation Restricted Payout - 129744
Suitability Information and Acknowledgement - 154278
Suitability Profile - 153060
Suitability Review and Acknowledgement - 139982
Tax Withholding Election - 130627
Telephone-Electronic Transmission Authorization - 129685
Third Party Investment Advisor Program Operations Guide