Forms

APPLICATIONS AND FORMS

Below are links to all of American Century plansĀ applications and forms.
You can download the forms or, for some forms, complete & submit online.

Single Premium Fixed Annuity Applications
(for the states of AL, AK, AZ, AR, DC, GA, ID, IL, IN, KY, LA, MA, MD, MO, MS, MT,
NH, ND, NM, OH, PA, RI, TN, TX, UT, VT, WV, WY)

Single premium deferred annuity application Print/download Complete online
Single premium immediate annuity application Print/download Complete online
Single premium immediate annuity application (MCA) Print/download Complete online

Single Premium Fixed Annuity Applications
(for SC)

Single premium deferred annuity application Print/download Complete online
Single premium immediate annuity application Print/download Complete online
Single premium immediate annuity application (MCA) Print/download Complete online

Annuity Service Forms
(for all available states)

1035 exchange, transfer, or rollover Print/download
Withdrawal request Print/download Complete online
RMD request Print/download Complete online
Annuity claim Print/download
Annuity distributions – bank account change Print/download

State Specific Forms

Arkansas Repalcement Memorandum Print/download

Annuity Related Agent Forms

Buyer’s guide to fixed deferred annuities Print/download
Annuity Suitability Form Print/download
Form PTE 84-24 (for agents only) Print/download
Transfer out requirements Print/download
Advertising guidelines for agents Print/download

Policy Changes

Change in policy owner or beneficiary Print/download
Policy cancellation Print/download
Life insurance – bank draft or credit card authorization Print/download

Policy Reinstatement Request

Release of medical records (required with all reinstatement forms) Print/download
For application forms L-222, Term 5R Print/download
For application form L-222A Print/download
For application form L-222J – Preferred and Standard Print/download
For application form L-222J – Modified Print/download
For application form Term Print/download
For application form L-222B Print/download
For application form JT25 Print/download

Claim Related Forms

Annuity claim Print/download
Life insurance claim Print/download
Affidavit of lost policy Print/download
Release of medical records Print/download
Affidavit of next of kin Print/download

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