Form Number Description
Miscellaneous Non-Product Specific Forms
3600Assignment of Policy Release of Assignment
MONY-EFLOA ACHBank Acknowledgment and Authorization
11622Billing Disbursement Election Form
10481Change of Beneficiary and/or Rightsholder (Owner)
EFT500Electronic Funds Transfer (EFT)
GUL 503Group Universal Life Certificate Service Request Form
W-9IRS W-9 Tax Form
15584MONY GUL Changes to Established Certificates Reinstatement Application, General
4979MONY Service Request Form
149043Overnight Fee and Aknowledgement Form
12341Request For MONY-Matic Loan Repayment
15579Request for Optional Service Telephone Fax Authorization
MONY-RMD WithdrawalRMD Withdrawal Service Form
3559Statement as to Trustee-Beneficiary
3551Statement of Loss or Destruction
Annuities - B6000, C6000
15844LAFlexible Payment Deferred Annuity Service Request
15843LAFlexible Payment Deferred Annuity Surrender
15842LAFlexible Payment Deferred Annuity Systematic Withdrawal Enrollment
15246LALetter of Acceptance for Fund Transfers - Qualified, IRA and Non-Qualified Money
16237LAMONY 72(t) or 72(q) Substantially Equal Periodic Payment Exception Form
15189 - (B6000, C6000)MONY Master (FPVA) Dollar Cost Averaging Enrollment Form
13343LA - (B6000, C6000)MONY Master (FPVA) Service Request B6000/C6000
13345LAMONYMaster (FPVA) Service Request
13105 - (B6000)Variable Annuity Service Form
13362 - (B6000, C6000)Variable Annuity Service Request-VALUEMaster
15184LAVariable Annuity Systematic Withdrawal Enrollment Form (MONYMaster Product Only)
Annuities - 1VA, 1VAA, 2VA, 2VAA, 1VAC, 2VAC, 1VAL, 2VAL
15448LA - (1VA, 2VA)MONY/EFLOA Custom Master (FPVA) Systematic Withdrawal Enrollment Form
16066LA - (1VA, 2VA)MONY/EFLOA Custom Master Dollar Cost Averaging Enrollment Form (all states except NY)
16087LA - (1VAA, 2VAA)MONY/EFLOA Dollar Cost Averaging (DCA) Enrollment Form Variable Annuity
15444LA - (1VA, 2VA)MONY/EFLOA FPVA Surrender Loan 1VA 2VA
15761LA - (1VAA, 2VAA)MONY/EFLOA Variable Annuity FPVA Surrender/Withdrawal/Loan Form
15759LA - (1VA, 1VAA, 2VA, 2VAA, 1VAC, 2VAC, 1VAL,One-Time Transfer, Change of Allocations, Asset Rebalancing for Variable Annuity
15908LAVariable Annuity Surrender / Loan Form (all states except NY)
15911LA - (1VAC, 2VAC, 1VAL, 2VAL)Variable Annuity Systematic Withdrawal Enrollment Form (all states except NY)
Universal and Variable Life - B6000, C6000, 1VUL, 2VUL, 1SVL, 2SVL, 1VULA, 2SVULA, 2VULA, 2SVULA
15457LA - (1VUL, 2VUL, 1SVL, 2SVL)Custom Equity Master Custom Estate Master Systematic Withdrawal Enrollment
15542LA - (1VUL, 2VUL)Custom Equity Master/Custom Estate Master Dollar Cost Averaging Enrollment (all states except NY)
15455LA - (1VUL, 2VUL, 1SVL, 2SVL)Custom Equity Master/Custom Estate Master Surrender/Loan
15763LA - (Pre 6/3/2003 - 1VULA, 2SVULA, 2VULA, 2SMONY Dollar Cost Averaging (DCA) Enrollment Form Variable Universal Life/Survivorship VUL
16108LA - (Post 6/3/2003 - 1VULA, 2SVULA, 2VULA, 2MONY Dollar Cost Averaging(DCA) Enrollment Form Variable Universal Life - Introduced 6/2003
15625LA - (B6000, C6000)MONY Equity Master Dollar Cost Averaging Enrollment Form
15627LA - (B6000, C6000)MONY Equity Master Surrender/Loan
15454LA - (B6000, C6000, 1VUL, 2VUL, 1SVL, 2SVL, One-Time Tranfer, Change of Allocations, Asset Rebalancing Life
15755LA - (Pre 6/3/2003 - 1VULA, 2SVULA, 2VULA, 2SVariable Universal Life Surrender/Loan
16101LA - (Post 6/3/2003 - 1VULA, 2SVULA, 2VULA, 2Variable Universal Life Surrender/Loan - Introduced 6/2003
15778LA - (Pre 6/3/2003 - 1VULA, 2SVULA, 2VULA, 2SVariable Universal Life Systematic Withdrawal Enrollment Form
16110LA - (Post 6/3/2003 - 1VULA, 2SVULA, 2VULA, 2Variable Universal Life Systematic Withdrawal Enrollment Form - Introduced 6/2003
Whole Life and Universal and Variable Universal Life - B1, C1, 1UL, 2UL, 1SULA, 2SULA
4979MONY Service Request Form
Contract Service Unit
35264Direct Deposit Authorization
11363Federal Income Tax Statement of Elections