Withdraw from a Tax-Sheltered 403(b) Annuity Contract

Surrender or withdraw funds from a tax-sheltered annuity contract or 403 (b) request.

If you have an annuity issued in New York, download the form.

Instructions

Complete Form

Complete the appropriate areas and supply the information requested on the Tax-Sheltered Annuity Service Request form.

Signatures

Make sure to sign the form. Signatures must be current and signed within 30 days of receipt.

Submit form

Return the completed forms with any required documentation via U.S. mail, overnight mail or fax to Fidelity & Guaranty Life Insurance Company Service Center.

Postal Mail

Fidelity & Guaranty Life Insurance Company Service Center
P.O. Box 81497
Lincoln, NE 68501-1497

Overnight Mail

Fidelity & Guaranty Life Insurance Company Service Center
777 Research Drive
Lincoln, NE 68521

Fax

402-328-2266

Allow 7 days to process

Fidelity & Guaranty Life Insurance Company will process the request within 7 business days of receipt.

Confirmation

A confirmation of this change will be mailed to the owner's address of record upon completion along with a countersigned copy of the Service Request form.

Featured Box Image

Request for Disbursement Form admin 5589

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Still have questions?

Reach out to our customer service.