JACKSON NATIONAL FORMS
Annuity Benefit Form - X0250
Annuity Partial or Full Liquidation Request - X3101
Annuity Service Request - N0365 [NY]
Annuity Service Request - X0365
Application Enrollment for Group Annuity Certificate - NF3010 [NY]
Armed Forces Product Disclosure - NADV14668 [NY]
Armed Forces Product Disclosure - XADV14668
AscenderPlus Select Annuity Application - X100 [Generic]
AscenderPlus Select Annuity Application - X100A [IN-TN-VA-WI]
AscenderPlus Select Annuity Application - X100AZ [AZ]
AscenderPlus Select Annuity Application - X100B [IL-KS-NC-OK]
AscenderPlus Select Annuity Application - X100CT [CT]
AscenderPlus Select Annuity Application - X100FL [FL]
AscenderPlus Select Annuity Application - X100MA [MA]
AscenderPlus Select Annuity Application - X100MN [MN]
AscenderPlus Select Annuity Application - X100NH [NH]
AscenderPlus Select Annuity Application - X100NV [NV]
AscenderPlus Select Annuity Application - X100OR [OR]
AscenderPlus Select Annuity Application - X100TX [TX]
AscenderPlus Select Annuity Application - X100VT [VT]
AscenderPlus Select Annuity Application - X100WA [WA]
AscenderPlus Select Statement Of Understanding - JDI4252 [Generic]
AscenderPlus Select Statement Of Understanding - JDI4252OR [OR]
AscenderPlus Select Statement Of Understanding - JDI4252VT [VT]
Authorization to Disclose Policy Information - N3512 [NY]
Authorization to Disclose Policy Information - NV3512 [NY]
Beneficiary Designation with Pre-Selected Death Benefit Election - N4219 [NY]
Beneficiary Designation with Pre-Selected Death Benefit Election - N4219G [NY]
Beneficiary Designation With Pre-Selected Death Benefit Election - X4219 [AO Except NY]
Binding Arbitration Agreement - Z3121 [MS]
Buyer's Guide to Annuities - X1292A [NV-UT]
Buyer's Guide to Annuities - X1292NH [NH]
Capital Protection Disclosure - N3144 [NY]
Collateral Assignment - N0642 [NY]
Comparative Information - X3498FL [FL]
Consumer Suitability Acknowledgement Form - N0950 [NY]
Consumer Suitability Acknowledgement Form - N0950G [NY]
Consumer Suitability Acknowledgement Form - X0950 [Multi-State]
Consumer Suitability Acknowledgement Form - X0950NJ [NJ]
DCA Directed Transfer - V2390 [WA]
DD Traditional And Target Select App - X0928HRI [RI]
Definition of Replacement - N0512B [NY]
Designated Beneficiary Hold Harmless Agreement - X2907
Direct Rollover Indemnification Agreement - N3203 [NY]
Direct Rollover Indemnification Agreement - X3203
Disclosure and Comparison of Annuity Contracts - X0951FL [FL]
Disclosure for Annuity Early Withdrawals - X4101 [IL-KS-NC-OK]
Disclosure for Annuity Early Withdrawals - X4101MA [MA]
Disclosure for Early Withdrawal - Surr-WD Charge - X4100MA [MA]
Disclosure Regarding 2 Percent Contract Enhancement Endorsement - NV4100 [NY]
Disclosure Regarding 2 Percent Contract Enhancement Endorsement - NV4108 [NY]
Disclosure Regarding 3 Percent Contract Enhancement Endorsement - NV4102 [NY]
Disclosure Regarding 4 Percent Contract Enhancement Endorsement - NV4106 [NY]
Disclosure Statement (Annuity To Annuity Replacement Only) - N3312 [NY]
Disclosure Statement (Life to Life and Life to Annuity) - N3313 [NY]
Disclosure Withdrawals Waiver - X4100 [IL-KS-NC-OK]
Electronic Funds Transfer (EFT) From Bank Account - NV0297 [NY]
Electronic Funds Transfer (EFT) From Bank Account - X0297 [AO Except NY]
Elite 90 Application - X500 [Generic]
Elite 90 Application - X500A [IN-TN-VA-WI]
Elite 90 Application - X500B [IL-KS-NC-OK]
Elite 90 Application - X500C [AZ-CA]
Elite 90 Application - X500CT [CT]
Elite 90 Application - X500FL [FL]
Elite 90 Application - X500MA [MA]
Elite 90 Application - X500MN [MN]
Elite 90 Application - X500OR [OR]
Elite 90 Application - X500WA [WA]
Elite 90 Consumer Brochure - XADV4045
Elite 90 Consumer Brochure - XADV4045OR [OR]
Elite Annual Reset Application - X3581OR [OR]
Elite Annual Reset Application - X700 [Generic]
Elite Annual Reset Application - X700A [IN-TN-VA-WI]
Elite Annual Reset Application - X700B [KS-NC-OK]
Elite Annual Reset Application - X700C [AZ-CA]
Elite Annual Reset Application - X700CT [CT]
Elite Annual Reset Application - X700FL [FL]
Elite Annual Reset Application - X700IL [IL]
Elite Annual Reset Application - X700MA [MA]
Elite Annual Reset Application - X700MN [MN]
Elite Annual Reset Application - X700TX [TX]
Elite Annual Reset Application - X700UT [UT]
Elite Annual Reset Application - X700WA [WA]
Elite Annual Reset Statement Of Understanding - XADV8704 [All Except CT-IL-MN-OR-UT-VT-WA]
Elite Annual Reset Statement Of Understanding - XADV8704C [CT-IL-MN-UT-WA]
Elite Annual Reset Statement Of Understanding - XADV8704OR [OR]
Elite Annual Reset Statement Of Understanding - XADV8704VT [VT]
Elite Choice Application - X800 [Generic]
Elite Choice Application - X800A [IN-TN-VA-WI]
Elite Choice Application - X800B [KS-NC-OK]
Elite Choice Application - X800C [AZ-CA]
Elite Choice Application - X800CT [CT]
Elite Choice Application - X800FL [FL]
Elite Choice Application - X800IL [IL]
Elite Choice Application - X800MA [MA]
Elite Choice Application - X800MN [MN]
Elite Choice Application - X800NV [NV]
Elite Choice Application - X800TX [TX]
Elite Choice Application - X800UT [UT]
Elite Choice Application - X800VT [VT]
Elite Choice Application - X800WA [WA]
Elite Choice Rewards Application - X850 [Generic]
Elite Choice Rewards Application - X850A [IN-TN-VA-WI]
Elite Choice Rewards Application - X850B [KS-NC-OK]
Elite Choice Rewards Application - X850C [AZ-CA]
Elite Choice Rewards Application - X850CT [CT]
Elite Choice Rewards Application - X850FL [FL]
Elite Choice Rewards Application - X850IL [IL]
Elite Choice Rewards Application - X850MA [MA]
Elite Choice Rewards Application - X850MN [MN]
Elite Choice Rewards Application - X850NV [NV]
Elite Choice Rewards Application - X850TX [TX]
Elite Choice Rewards Application - X850UT [UT]
Elite Choice Rewards Application - X850VT [VT]
Elite Choice Rewards Application - X850WA [WA]
Elite Choice Rewards Statement Of Understanding - XADV12651 [Generic]
Elite Choice Rewards Statement Of Understanding - XADV12651CTWA [CT-WA]
Elite Choice Rewards Statement Of Understanding - XADV12651ILUTMN [IL-MN-UT]
Elite Choice Rewards Statement Of Understanding - XADV12651TX [TX]
Elite Choice Rewards Statement Of Understanding - XADV12651VT [VT]
Elite Choice Statement Of Understanding - XADV12650 [Generic]
Elite Choice Statement Of Understanding - XADV12650C [CT-IL-MN-UT-WA]
Elite Choice Statement Of Understanding - XADV12650VT [VT]
Fixed and Variable Annuity Application - NV3573 [NY]
Fixed and Variable Annuity Application - V3573 [Generic]
Fixed and Variable Annuity Application - V3573A [TN-VA-WI]
Fixed and Variable Annuity Application - V3573B [IL-KS-NC-OK]
Fixed and Variable Annuity Application - V3573C [AZ-CA]
Fixed and Variable Annuity Application - V3573CT [CT]
Fixed and Variable Annuity Application - V3573FL [FL]
Fixed and Variable Annuity Application - V3573IN [IN]
Fixed and Variable Annuity Application - V3573MA [MA]
Fixed and Variable Annuity Application - V3573MD [MD]
Fixed and Variable Annuity Application - V3573MN [MN]
Fixed and Variable Annuity Application - V3573NH [NH]
Fixed and Variable Annuity Application - V3573NV [NV]
Fixed and Variable Annuity Application - V3573OR [OR]
Fixed and Variable Annuity Application - V3573VT [VT]
Fixed and Variable Annuity Application - V3573WA [WA]
Fixed Annuity Application - N5300 [NY]
Fixed Annuity Application - X0928FMD [MD]
Fixed Annuity Application - X0928FRI [RI]
Fixed Annuity Application - X5300 [Generic]
Fixed Annuity Application - X5300A [IN-TN-VA-WI]
Fixed Annuity Application - X5300B [IL-KS-NC-OK]
Fixed Annuity Application - X5300C [AZ-CA]
Fixed Annuity Application - X5300CT [CT]
Fixed Annuity Application - X5300D [AK]
Fixed Annuity Application - X5300FL [FL]
Fixed Annuity Application - X5300MA [MA]
Fixed Annuity Application - X5300MN [MN]
Fixed Annuity Application - X5300OR [OR]
Fixed Annuity Application - X5300WA [WA]
Fixed Annuity Death Benefit Claim Form - Z1142
Fixed Annuity Death Benefit Claim Form - Z1142MO [MO]
Fixed Annuity Good Order Checklist - N3848 [NY]
Fixed Annuity Good Order Checklist - X3643 [All Except NY]
Fixed Annuity Periodic Income Payment (PIP) Request - X2635
Fixed Annuity Systematic Withdrawal Request - X2055
Fixed Index Annuity Good Order Checklist - X3641 [All Except NY]
Fixed Index Annuity Systematic RMD Request - X2056
FutureGuard 6 GMIB Election-Cancellation Form - NV6237 [NY]
FutureGuard 6 GMIB Election-Cancellation Form - V6237
GMWB Optional Benefit Election - NV4390 [NY]
GMWB Optional Benefit Election - V4390
Guaranteed Period Annuity Application - F2492CRI [RI]
Immediate Annuity App - N0919 [NY]
Immediate Annuity App - X0919 [All Except CA-FL-NY-TN-WI]
Immediate Annuity App - X0919A [TN-WI]
Immediate Annuity App - X0919CA [CA]
Immediate Annuity App - X0919FL [FL]
Immediate Annuity Select Good Order Checklist - X3644 [All Except NY]
Important Disclosure Regarding the 1 Percent Additional Interest Rate - N3141 [NY]
Important Disclosure Regarding the 2 Percent Additional Interest Rate - N3143 [NY]
Indemnification Agreement - N2909 [NY]
Indemnification Agreement - X2909 [AO Except NY]
Information Sharing Agreement and Approved Vendor Certification - N2367 [NY]
Internal Exchange Request - N3170 [NY]
Internal Exchange Request - X3170 [AO Except NY]
Internal Florida Replacement Disclosure - X2614FL [FL]
Jackson Assure Whole Life Good Order Ticket - X5333
Juvenile Beneficiary Trustee Designation - X1335
Letter of Instruction - X4250
Life Good Order Checklist - X5133
Minnesota Insolvency Form - X1528MN [MN]
Multiple Ownership Designation Supplement - N1006 [NY]
Multiple Ownership Designation Supplement - X1006 [Generic]
Notice Regarding Replacement - N0512A [NY]
Notice Regarding Standards for Medi-Cal Eligibility - X3856CA [CA]
Official Receipt - Z0307 [AL-TX]
Optional Benefit Election Guaranteed Minimum Withdrawl Benefit - NV6183 [NY]
Optional Benefit Election Guaranteed Minimum Withdrawl Benefit - V6183
Partial Withdrawal - NV3781 [NY]
Partial Withdrawal - V3781 [Generic]
Perspective Advisors Fund Transfer Request - V4282 [Generic]
Perspective Advisors II Application - NV4973 [NY]
Perspective Advisors II Application - V4473 [Generic]
Perspective Advisors II Application - V4473A [TN-VA-WI]
Perspective Advisors II Application - V4473B [IL-KS-NC-OK]
Perspective Advisors II Application - V4473C [AZ-CA]
Perspective Advisors II Application - V4473CT [CT]
Perspective Advisors II Application - V4473FL [FL]
Perspective Advisors II Application - V4473IN [IN]
Perspective Advisors II Application - V4473MA [MA]
Perspective Advisors II Application - V4473MD [MD]
Perspective Advisors II Application - V4473MN [MN]
Perspective Advisors II Application - V4473NH [NH]
Perspective Advisors II Application - V4473NV [NV]
Perspective Advisors II Application - V4473OR [OR]
Perspective Advisors II Application - V4473VT [VT]
Perspective Advisors II Application - V4473WA [WA]
Perspective Advisors II Directed Transfer - NV4490 [NY]
Perspective Advisors II Directed Transfer - V4490 [Generic]
Perspective Advisors II Fund Transfer Request - V4482
Perspective Advisors II Systematic Investment - NV4475 [NY]
Perspective Advisors II Systematic Investment - V4475 [Generic]
Perspective Fund Transfer Request - V4382 [Generic]
Perspective II Application - NV4873 [NY]
Perspective II Application - V4173 [Generic]
Perspective II Application - V4173A [TN-VA-WI]
Perspective II Application - V4173B [IL-KS-NC-OK]
Perspective II Application - V4173C [AZ-CA]
Perspective II Application - V4173CT [CT]
Perspective II Application - V4173FL [FL]
Perspective II Application - V4173IN [IN]
Perspective II Application - V4173MA [MA]
Perspective II Application - V4173MD [MD]
Perspective II Application - V4173MN [MN]
Perspective II Application - V4173NH [NH]
Perspective II Application - V4173NV [NV]
Perspective II Application - V4173OR [OR]
Perspective II Application - V4173VT [VT]
Perspective II Application - V4173WA [WA]
Perspective II Systematic Investment Form - NV2375 [NY]
Perspective II Systematic Investment Form - V2375 [AO Except NY]
Perspective L Product Summary for Contract Enhancements - V4606MN [MN]
Perspective L Series Application - NV4673 [NY]
Perspective L Series Application - V4673 [Generic]
Perspective L Series Application - V4673A [TN-VA-WI]
Perspective L Series Application - V4673B [IL-KS-NC-OK]
Perspective L Series Application - V4673C [AZ-CA]
Perspective L Series Application - V4673CT [CT]
Perspective L Series Application - V4673FL [FL]
Perspective L Series Application - V4673IN [IN]
Perspective L Series Application - V4673MA [MA]
Perspective L Series Application - V4673MD [MD]
Perspective L Series Application - V4673MN [MN]
Perspective L Series Application - V4673NH [NH]
Perspective L Series Application - V4673NV [NV]
Perspective L Series Application - V4673OR [OR]
Perspective L Series Application - V4673VT [VT]
Perspective L Series Application - V4673WA [WA]
Perspective Rewards Application - NV5473 [NY]
Perspective Rewards Application - V5473 [Generic]
Perspective Rewards Application - V5473A [TN-VA-WI]
Perspective Rewards Application - V5473B [IL-KS-NC-OK]
Perspective Rewards Application - V5473C [AZ-CA]
Perspective Rewards Application - V5473CT [CT]
Perspective Rewards Application - V5473FL [FL]
Perspective Rewards Application - V5473IN [IN]
Perspective Rewards Application - V5473MA [MA]
Perspective Rewards Application - V5473MD [MD]
Perspective Rewards Application - V5473MN [MN]
Perspective Rewards Application - V5473MO [MO]
Perspective Rewards Application - V5473NH [NH]
Perspective Rewards Application - V5473NV [NV]
Perspective Rewards Application - V5473VT [VT]
Perspective Rewards Application - V5473WA [WA]
Producer as Trustee - Beneficiary Acknowledgement Form - N3859 [NY]
Producer as Trustee - Beneficiary Acknowledgement Form - X3859 [All Except NY]
Product Summary Contract Enhancement - V4106MN [MN]
Release of Assignment - X0901
Replacement Form - External - X0512KS [KS]
Replacement Form - Internal - X0512IKS [KS]
Replacement Form - X0512AK [AK]
Replacement Form - X0512AR [AR]
Replacement Form - X0512CA [CA]
Replacement Form - X0512COMBO [Multi-State]
Replacement Form - X0512DE [DE]
Replacement Form - X0512FL [FL]
Replacement Form - X0512GA [GA]
Replacement Form - X0512ID [ID]
Replacement Form - X0512IL [IL]
Replacement Form - X0512IN [IN]
Replacement Form - X0512KY [KY]
Replacement Form - X0512MA [MA]
Replacement Form - X0512MI [MI]
Replacement Form - X0512MN [MN]
Replacement Form - X0512MO [MO]
Replacement Form - X0512NJ [NJ]
Replacement Form - X0512NV [NV]
Replacement Form - X0512NV-A [NV]
Replacement Form - X0512NV-B [NV]
Replacement Form - X0512OK [OK]
Replacement Form - X0512PA [PA]
Replacement Form - X0512SD [SD]
Replacement Form - X0512TN [TN]
Replacement Form - X0512UT [UT]
Replacement Form - X0512VA [VA]
Replacement Form - X0512WA [WA]
Replacement Form - X0512WY [WY]
Replacement Instructions - XADV5790 [Multi-State]
Replacement Notice - X3491
Request for Transfer or Exchange of Assets - IMG - N3783 [NY]
Request for Transfer or Exchange of Assets - X3783 [AO Except NY]
Roth Conversion Request Form - N4270 [NY]
Roth Conversion Request Form - X4270 [Generic]
Sales Material Checklist (Reg 60) - N3557 [NY]
Sales Material Checklist (Reg 60) - NV3557 [NY]
Select Annual Reset Annuity Application - X350 [Generic]
Select Annual Reset Annuity Application - X350A [IN-TN-VA-WI]
Select Annual Reset Annuity Application - X350B [IL-KS-NC-OK]
Select Annual Reset Annuity Application - X350C [AZ-CA]
Select Annual Reset Annuity Application - X350CT [CT]
Select Annual Reset Annuity Application - X350FL [FL]
Select Annual Reset Annuity Application - X350MA [MA]
Select Annual Reset Annuity Application - X350MN [MN]
Select Annual Reset Annuity Application - X350NH [NH]
Select Annual Reset Annuity Application - X350NV [NV]
Select Annual Reset Annuity Application - X350OR [OR]
Select Annual Reset Annuity Application - X350TX [TX]
Select Annual Reset Annuity Application - X350VT [VT]
Select Annual Reset Statement Of Understanding - JFI4229 [Generic]
Select Annual Reset Statement Of Understanding - JFI4229OR [OR]
Select Annual Reset Statement Of Understanding - JFI4229TX [TX]
Select Annual Reset Statement Of Understanding - JFI4229VT [VT]
Single-Premium Deferred Annuity Disclosure - X1192 [KS-OH]
Special Dollar Cost Averaging Supplemental Application - NV3647 [NY]
Statement Regarding Existing Policies - X3401 [Multi-State]
Statement Regarding Existing Policies - X3401NC [NC]
Systematic Investment - V4277
Systematic Withdrawal - V4370 [AO Except NY]
Systematic Withdrawal Form (Non-Qualified Plans) - NV4377 [NY]
Target Select App - V2492C [All Except CA-KY-MA-OR-TN-WI]
Target Select App - V2492CNC [NC]
Target Select App - X2492CKY [KY]
Target Select Good Order Checklist - X3640 [All Except NY]
Telephone Authorization Request - NV3782 [NY]
Trustee Certification of Investment Powers - X5335
VA Income Election Option Form - V4374 [AO Except NY]
Variable Annuity Good Order Checklist - NV3848 [NY]
Variable Annuity Good Order Checklist - V3848 [Generic]
Variable Annuity Systematic Withdrawal Request - NV4370
