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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.
| Transaction | In Writing | By fax | By phone | Online | |
|---|---|---|---|---|---|
New accounts and additional purchases |
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| Funding | Additional Payment (Add On) Receipt | > Download PDF | |||
| IRA to Roth Conversion - In House | > Download PDF | 612.547.1891 | |||
| Transfer Roll-over Exchange - Incoming | > Download PDF | ||||
| TSA/TSCA Transfer Request | > Download PDF | ||||
| Non State Specific Required forms | 403(b) Information Sharing Agreement | > Download PDF | 612.547.1717 | ||
| Tax-Deferred Retirement Plan Acknowledgement | > Download PDF | 612.547.1717 | |||
| Community States Spousal Consent | > Download PDF | 612.547.1717 | |||
| State Specific Required Forms | CA - Disclosure for Residents Age 60 and Older | > Download PDF | 612.547.1717 | ||
| CA - Financial Products Disclosure | > Download PDF | 612.547.1717 | |||
| MA - Early Withdrawal, Terminal Illness Disclosure | > Download PDF | 612.547.1717 | |||
Withdrawals |
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| Additional Forms | Statement of Disability | > Download PDF | 612.547.1732 | ||
| Death Claims | Death Claim Statement | > Download PDF | |||
| Divorce | Annuity Divorce Surrender Form | > Download PDF | 612.547.1732 | ||
| IRA/Qualified Plans | 2011 Inherited IRA Required Minimum Distribution | > Download PDF | 612.547.1732 | ||
| 2012 Inherited IRA Required Minimum Distribution | > Download PDF | ||||
| 2011 Required Minimum Distribution | > Download PDF | 612.547.1732 | 1.800.333.3437 | Yes (one-time withdrawal) | |
| 2012 Required Minimum Distribution | > Download PDF | 612.547.1732 | 1.800.333.3437 | Yes (one-time withdrawal) | |
| 403(b)/TSA Withdrawal | > Download PDF | 612.547.1732 | |||
| IRA - Excess Contribution Removal Request | > Download PDF | 612.547.1891 | |||
| IRA Internal Recharacterization | > Download PDF | 612.547.1891 | |||
| Partial/Full Surrenders | Withdrawal as Outgoing Transfer Roll-over Exchange - Outgoing | > Download PDF | |||
| Withdrawal for Substantially Equal Periodic Payment | > Download PDF | 612.547.1732 | |||
| Withdrawal Partial or Full One-Time | > Download PDF | 612.547.1732 (up to $100,000 ) | 1.800.333.3437 (up to $100,000) | Yes (one-time withdrawal) | |
| Systematic Withdrawals | Withdrawal Systematically (Recurring) | > Download PDF | 612.547.1732 | 1.800.333.3437 | Yes |
Contract maintenance |
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| Advisor Specific | Agent of Record Change Change servicing advisor or agent on contract | > Download PDF | 612.317.3726 | ||
| Client Specific | Privacy Notice | > Download PDF | |||
| Contract Specific | Customer Service Requests (Address, Beneficiary, Name changes, as well as Spousal Existence) | > Download PDF | 612.317.3726 (address change only) | 1.800.333.3437 (address change only) | Yes (address change only) |
| Affidavit of Lost Annuity Contract | > Download PDF | 612.317.3726 | |||
| Collateral Assignment Assignment of Annuity as collateral | > Download PDF | ||||
| 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. | > Download PDF | 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. | > Download PDF | 612.317.3726 | 1.800.333.3437 | PN Change | |
| Death Benefit Pre-Election for Payment | > Download PDF | 612.547.1732 | |||
| Ownership as Joint Non-spousal | > Download PDF | 612.547.1717 | |||
| Ownership as Non-natural | > Download PDF | 612.547.1717 | |||
| Ownership Transfer | > Download PDF | ||||
| Release and Reassignment of Collateral Assignment | > Download PDF | ||||
| Telephone Transaction Authorization Authorization for advisor or agent to request certain transactions on the contract. | > Download PDF | 612.317.3726 | |||
| Trustee Certificate | > Download PDF | 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.
