Forms

Several of our most popular transactions are available to complete and submit entirely online:

  • One-time Withdrawal
  • Systematic Withdrawals
  • Address Changes
  • Portfolio Navigator Changes
  • Duplicate Statement Requests

To complete a transaction online, you must first log in to your contract. Once logged in, go to the Transactions section and select the appropriate transaction.

Print-friendly forms for transfers, payouts and more.

All our forms are available as downloadable PDFs. If you can't find the forms you're looking for, contact us.

Please note: We only accept original documents for outgoing trustee-to-trustee transfers, 1035 exchanges, beneficiary changes, death claim statements and surrenders over $100,000.

Please do not send fax copies. If you're requesting a 1035 exchange or trustee-to-trustee transfer, we'll need the appropriate forms from the requesting company.

View New York Forms

 

  Transaction In Writing By fax By phone Online
New accounts and additional purchases
Funding Additional Payment (Add On) Receipt      
IRA to Roth Conversion - In House 612.547.1891    
Transfer Roll-over Exchange - Incoming      
TSA/TSCA Transfer Request      
Non State Specific Required forms 403(b) Information Sharing Agreement 612.547.1717    
Community States Spousal Consent 612.547.1717    
State Specific Required Forms CA - Disclosure for Residents Age 60 and Older 612.547.1717    
CA - Financial Products Disclosure 612.547.1717    
MA - Early Withdrawal, Terminal Illness Disclosure 612.547.1717    
NC - Financial Professional Attestation 612.547.1717    
Withdrawals
Additional Forms Statement of Disability 612.547.1732    
Death Claims Death Claim Statement      
Divorce Annuity Divorce Surrender Form 612.547.1732    
IRA/Qualified Plans 2013 Inherited IRA Required Minimum Distribution      
2013 Required Minimum Distribution 612.547.1732 1.800.333.3437 Yes
(one-time withdrawal)
2014 Inherited IRA Required Minimum Distribution      
2014 Required Minimum Distribution 612.547.1732 1.800.333.3437 Yes
(one-time withdrawal)
403(b)/TSA Withdrawal 612.547.1732    
IRA - Excess Contribution Removal Request 612.547.1891    
IRA Internal Recharacterization 612.547.1891    
Partial/Full Surrenders Withdrawal as Outgoing Transfer Roll-over Exchange - Outgoing      
Withdrawal for Substantially Equal Periodic Payment 612.547.1732    
Withdrawal Partial or Full One-Time 612.547.1732 (up to $100,000 ) 1.800.333.3437 (up to $100,000) Yes
(one-time withdrawal)
Systematic Withdrawals Withdrawal Systematically (Recurring) 612.547.1732 1.800.333.3437 Yes
Contract maintenance
Agent Specific Agent of Record Change. Change servicing agent or agent on contract. 612.317.3726    
Agent Appointment Form 612.547.1671    
Client Specific Privacy Notice      
Contract Specific Customer Service Requests (Address, Beneficiary, Name changes, as well as Spousal Existence) 612.317.3726 1.800.333.3437 (address change only) Yes (address change only)
Affidavit of Lost Annuity Contract 612.317.3726    
Collateral Assignment Assignment of Annuity as collateral      
Portfolio Stabilizer fund Election form 612.317.3726 1.800.333.3437  
Investment Options Form for contracts purchased on or after 5-1-2007 Portfolio Navigator, Dollar Cost Averaging, Fund Rebalance, Interest Sweep, Fund transfer, Systematic Investment (Add On) set up, change and discontinue. 612.317.3726 1.800.333.3437 PN Change
Investment Options Form for contracts purchased on or before 4-30-2007 Portfolio Navigator, Dollar Cost Averaging, Fund Rebalance, Interest Sweep, Fund transfer, Systematic Investment (Add On) set up, change and discontinue. 612.317.3726 1.800.333.3437 PN Change
Death Benefit Pre-Election for Payment 612.547.1732    
Ownership as Non-natural 612.547.1717    
Ownership Transfer      
Release and Reassignment of Collateral Assignment      
Telephone Transaction Authorization Authorization for advisor or agent to request certain transactions on the contract. 612.317.3726    
Trustee Certificate 612.317.3726    

RiverSource Distributors, Inc. (Distributor), Member FINRA. Insurance and annuity products are issued by RiverSource Life Insurance Company and in New York, by RiverSource Life Insurance Co. of New York, Albany, New York. Only RiverSource Life Insurance Co. of New York is authorized to sell insurance and annuities in New York.