Forms

Customer Service Forms

American Equity of New York is committed to provide superior customer service and provides our clients and representatives easy access to preview, download, or email the necessary forms for your annuity contract needs. We thank you for your business.

Form Name	View	Download	Email
Application for Settlement Option Benefits	View	Download	Email
Beneficiary Claim Form - Deaths Occurring On or Before 12.31.19	View	Download	Email
Beneficiary Claim Form - Non-Qualified Account (i.e. other than IRAs)- Deaths Occurring On or After 01.01.20	View	Download	Email
Beneficiary Claim Form - Qualified Account (i.e. IRAs) - Death Occurring On or After 01.01.20	View	Download	Email
Beneficiary Claim Guide - Deaths Occurring On or Before 12.31.19	View	Download	Email
Beneficiary Claim Guide - Non-Qualified Account (i.e. other than IRAs)- Deaths Occurring On or After 01.01.20	View	Download	Email
Beneficiary Claim Guide - Qualified Account (i.e. IRAs) - Death Occurring On or After 01.01.20	View	Download	Email
Certification of Trust Agreement	View	Download	Email
Change of Beneficiary	View	Download	Email
Election of Withholding	View	Download	Email
Electronic Funds Transfer (EFT)	View	Download	Email
Form IT-2104-P, New York Tax Withholding Form	View	Download	Email
Form W-8BEN, IRS Certificate of Foreign Status of Beneficial Owner	View	Download	Email
Information Update Request	View	Download	Email
Nursing Care Verification	View	Download	Email
Ownership Change	View	Download	Email
Partial Withdrawal Request	View	Download	Email
Pre-Authorized Payments (PAC)	View	Download	Email
Required Minimum Distribution Withdrawal Request	View	Download	Email
Roth Conversion	View	Download	Email
Systematic Withdrawal Request	View	Download	Email
Terminal Illness Verification	View	Download	Email
Third Party Payee Authorization Form	View	Download	Email
W9	View	Download	Email