Servicing forms

Servicing Forms

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One-time Withdrawal
Systematic Withdrawal
Address Change
Portfolio Navigator Change
Duplicate Statement Request
Beneficiary Change

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For all other requests, narrow your search for printer-friendly PDF forms using the filters below.
If you can't find the forms you need, contact us or call 800.862.7919.

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Topics: Top forms | Contract maintenance | New accounts and additional purchases | Withdrawals

Top forms

W-4R Federal Withholding Instructions for RiverSource (117574)
W-4P Federal Withholding Instruction for RiverSource Annuitized Contracts (117575)
Customer Service Request
Telephone, Electronics and Change Instructions Authorization
Third Party Consent
Transfer Rollover Exchange - Outgoing

Agent Specific

Agent Information Form
Agent of Record Change

Client Specific

Telephone, Electronic and Change Instructions Authorization
By Phone: 800.862.7919
Privacy Notice
Third Party Consent
By Phone: 800.862.7919

Contract Specific

A guide to your RiverSource Life IRA
Annuitization Start Date Postponement Request
Collateral Assignment Assignment of Annuity as Collateral
Customer Service Request
Available Online
By Phone: 800.333.3437 (Address change only)
Investment Options Form for contracts purchased on or before 4/30/2007
Available Online
By Phone: 800.333.3437
Investment Options form for contracts sold on or after 5/1/2007
Available OnlineBy Phone: 800.333.3437
Portfolio Stabilizer Fund Election Form
By Phone: 800.333.3437
Death Benefit Pre-Election for Payment
Release and Reassignment of Collateral Assignment
Telephone Transaction Authorization
Ownership Transfer
Trustee Certificate

Contract maintenance

Agent, client, and contract-specific maintenance forms

Agent Specific

Agent Appointment Form
Agent of Record Change

Client Specific

Telephone, Electronic and Change Instructions Authorization
By Phone: 800.862.7919
Privacy Notice
Third Party Consent
By Phone: 800.862.7919

Contract Specific

A guide to your RiverSource Life IRA
Annuitization Start Date Postponement Request
Collateral Assignment Assignment of Annuity as Collateral
Customer Service Request
Available Online
By Phone: 800.333.3437 (Address change only)
Investment Options Form for contracts purchased on or before 4/30/2007
Available Online
By Phone: 800.333.3437
Investment Options form for contracts sold on or after 5/1/2007
Available Online
By Phone: 800.333.3437
Portfolio Stabilizer Fund Election Form
By Phone: 800.333.3437
Death Benefit Pre-Election for Payment
Release and Reassignment of Collateral Assignment
Telephone Transaction Authorization
Ownership Transfer
Trustee Certificate

New accounts and additional purchases

Funding, purchase and other required forms

Funding

Additional Payment (Add On) Receipt
IRA to Roth Conversion - In House
Systematic Investment Plan
Transfer Roll-over Exchange - Incoming

Non State Specific Required Forms

403(b) Information Sharing Agreement - 275052
Community States Spousal Consent

State Specific Required Forms

Financial Products Disclosure for CA Residents 65 and Older
CA - Disclosure for Residents Age 60 and Older

Withdrawals

RMD, partial/full surrender, death claims and other withdrawal-related forms

Additional Forms

Statement of Disability

Divorce

Annuity Divorce Surrender Form

IRA/Qualified Plans

Required Minimum Distribution Request
Available Online
By Phone: 800.333.3437
403(b) /TSA Withdrawal
IRA Internal Recharacterization
IRA - Excess Contribution Removal Request

Partial/Full Surrenders

Withdrawal as Outgoing Transfer Roll-over Exchange - Outgoing
Withdrawal for Substantially Equal Periodic Payment

Topics: Top forms

Top forms

Death Claim Statement
Death Claim Deferral Request
Preference Beneficiary Affidavit NY OD PA
Required Minimum Distribution Request

Topics: Top forms | Account maintenance | Account funding and money movement

Top forms

Change of Beneficiary (38120)
Change of Ownership/Annuitant (38105)
Outgoing Annuity Tax-Qualified Transfer/Rollover (138065)
Outgoing Non-Qualified 1035 Exchange (138066)

Account maintenance

Change of Ownership/Annuitant
Portfolio Stabilizer Election Forms
Pre-Election for Payment of Death Benefits
Telephone, Electronic Transaction and Change Instruction Authorization
Release of Collateral Assignment

Account funding and money movement

Annuitization Request or Reallocation for Variable Payouts
Outgoing Annuity Tax Qualified Transfer/Rollover
Outgoing Non-Qualified 1035 Exchange

Topics: Top forms

Top forms

W-4R Federal Withholding Instructions for RiverSource (117574)
W-4P Federal Withholding Instruction for RiverSource Annuitized Contracts (117575)
Annuity Service Request Form
Distribution Due to Divorce
Annuity Change of Ownership
Annuity Change of Beneficiary
Required Minimum Distribution Request

Topics: Top forms | All death claim forms

Top forms

Insurance and Annuity Death Claim Statement
Annuitization Request for Death Claims
Insurance and Annuity Change of Ownership Due to Death

All death claim forms

Insurance and Annuity Death Claim Statement
Annuitization Request for Death Claims
Insurance and Annuity Change of Ownership Due to Death
RiverSource Beneficiary(ies) Identification and Location Assistance Form
Spousal Continuation of Death Riders Selection
Claim to Defer Payment of Annuity Death Benefit Proceeds
Release of Collateral Assignment of Life Insurance and Annuity for Death Claim Proceeds
RiverSource Death Claim Cover Sheet

Topics: Top forms | Contract maintenance | New accounts and additional purchases | Withdrawals

Top forms

Customer Service Request - NY
Portfolio Stabilizer Fund Election - NY
Telephone, Electronics and Change Instructions Authorization - NY
Third Party Consent - NY
Transfer Rollover Exchange - Outgoing-NY

Contract maintenance

Agent, client, and contract-specific maintenance forms

Agent specific

Agent Information Form
NY - Agent of Record Change

Client specific

Telephone, Electronic and Change Instructions Authorization
By Phone: 800.862.7919
Third Party Consent
By Phone: 800.862.7919

Contract specific

A guide to your RiverSource Life IRA
Annuitization Start Date Postponement Request
NY - Customer Service Requests
Available Online
By Phone: 800.504.0469 (address changes only)
NY - Investment Options Form for contracts purchased on or before 4/30/2007
Available Online
By Phone: 800.504.0469
NY - Investment Options form for contracts sold on or after 5/1/2007
Available Online
By Phone: 800.504.0469
NY - Portfolio Stabilizer fund Election Form
By Phone: 800.333.3437
NY - Telephone Transaction Authorization
NY - Transfer of Ownership
NY - Trustee Certificate

New accounts and additional purchases

Funding, purchase and other required forms

Funding

NY-Additional Payment (Add On) Receipt
IRA to Roth Conversion - In House
NY - Transfer Roll-over Exchange - Incoming
Systematic Investment Plan

State specific required forms

NY - Definition of Replacement
NY - Important Notice Regarding Replacements
NY - 403(b) Information Sharing Agreement

Withdrawals

RMD, partial/full surrender, death claims and other withdrawal-related forms

Additional forms

NY - Statement of Disability

Divorce

NY - Annuity Divorce Surrender Form
By Phone: 800.504.0469

IRA/Qualified plans

NY - Required Minimum Distribution Request
Available Online
By Phone: 800.504.0469
NY - IRA Excess Contribution Removal Request
NY - Request for IRA Internal Recharacterization
NY - Transfer Roll-over Exchange - Outgoing
NY - 403(b) Distribution

Partial/Full surrenders

NY - Substantially Equal Periodic Payment Withdrawal Request

Topics: Top forms | Account maintenance | Account funding and money movement

Top forms

W-4P Federal Withholding Instruction for RiverSource Annuitized Contracts (117557)
W-4R Federal Withholding Instruction for RiverSource Death Claim (117591)
W-4P Federal Withholding Instruction for RiverSource Death Claims on Annuitized Contracts (117596)
Change of Beneficiary (33032)
Change of Ownership/Annuitant (116931)
Outgoing Tax Qualified Annuity Transfer/Rollover (30482)
Outgoing Non-Qualified 1035 Exchange (30481)

Account maintenance

Change of Ownership/Annuitant
Portfolio Stabilizer Fund Election Form
Pre-Election for Payment of Death Benefits
Telephone, Electronic Transaction and Change Instructions Authorization
Release of Collateral Assignment

Account funding and money movement

Annuitization Request or Reallocation for Variable Payouts
Outgoing Annuity Tax Qualified Transfer/Rollover
Outgoing Non-Qualified 1035 Exchange
Statement of Disability

Topics: Top forms

Top forms

Death Claim Statement
Death Claim Deferral Request
Preference Beneficiary Affidavit Natl OD PA
Required Minimum Distribution Request

Topics: Top forms

Top forms

Annuity Service Request Form
Distribution Due to Divorce
Annuity Change of Ownership
Annuity Change of Beneficiary
Required Minimum Distribution Request

Topics: Top forms | Account maintenance | Estate settlement | Account funding and money movement

Top forms

Change of Beneficiary (33032)
Change of Ownership (F120)
Insurance & Annuity Death Claim Statement (140838)
Outgoing Tax Qualified Annuity Transfer/Rollover (30482)
Outgoing Non-Qualified 1035 Exchange (30481)

Account maintenance

Change of Ownership/Annuitant
Portfolio Stabilizer Fund Election Form - National
Release of Collateral assignment (200017)

Estate settlement

Insurance and Annuity Death Claim Statement
RiverSource Death Claim Cover Sheet

Account funding and money movement

Outgoing Annuity Tax Qualified Transfer or Direct Rollover from RiverSource Life Insurance Company
Outgoing Non-Qualified 1035 Exchange from RiverSource Life Insurance Company
Privileged Asset Annuity Change of Ownership Form
Privileged Asset Annuity Change of Beneficiary Form
Privileged Asset Annuity Withdrawal Request Form
Statement of Disability

Topics: Top forms

Top forms

Death Claim Statement
Claim to Defer Payment of Annuity Death Benefit Proceeds
Genworth (Fund One) Death Claim Statement
Investment Options Form for Variable Annuities Sold before 4/30/2007
Investment Options Form for Variable Annuities Sold on or after 5/1/2007
Outgoing Annuity Tax-Free Transfer/Rollover/Exchange Form
Preference Beneficiary Affidavit Natl OD
Release for Collateral Assignment
Required Minimum Distribution Request
Third Party Consent
Trustee Certificate

Topics: Top forms | Contract maintenance | New accounts and additional purchases | Withdrawals

Top forms

Customer Service Request
Death Claim Statement
Telephone, Electronics and Change Instructions Authorization
Third Party Consent
Transfer Rollover Exchange - Outgoing

Contract maintenance

Agent, client, and contract-specific maintenance forms

Agent specific

Agent Appointment Form
Agent of Record Change

Client specific

Telephone, Electronic and Change Instructions Authorization
By Phone: 800.862.7919
Privacy Notice
Third Party Consent
By Phone: 800.862.7919

Contract specific

Annuitization Start Date Postponement Request
Collateral Assignment Assignment of Annuity as Collateral
Customer Service Request
Available Online
By Phone: 800.333.3437 (Address change only)
Investment Options Form for contracts purchased on or before 4/30/2007
Available Online
By Phone: 800.333.3437
Investment Options form for contracts sold on or after 5/1/2007
Available Online
By Phone: 800.333.3437
Portfolio Stabilizer Fund Election Form
By Phone: 800.333.3437
Death Benefit Pre-Election for Payment
Release and Reassignment of Collateral Assignment
Telephone Transaction Authorization
Ownership Transfer
Trustee Certificate

New accounts and additional purchases

Funding, purchase and other required forms

Funding

Additional Payment (Add On) Receipt
IRA to Roth Conversion - In House
Transfer Roll-over Exchange - Incoming

Non state specific required forms

Community States Spousal Consent
403(b) Information Sharing Agreement - 275052

State specific required forms

Financial Products Disclosure for CA Residents 65 and Older
CA - Disclosure for Residents Age 60 and Older
MA - Early Withdrawal, Terminal Illness Disclosure

Withdrawals

RMD, partial/full surrender, death claims and other withdrawal-related forms

Additional forms

Statement of Disability

Death claims

Death Claim Statement
Death Claim Deferral Request

Divorce

Annuity Divorce Surrender Form

IRA/Qualified plans

Required Minimum Distribution Request
Available Online
By Phone: 800.333.3437
403(b) /TSA Withdrawal
IRA Internal Recharacterization
IRA - Excess Contribution Removal Request

Partial/Full surrenders

Withdrawal as Outgoing Transfer Roll-over Exchange - Outgoing
Withdrawal for Substantially Equal Periodic Payment

Topics: Top forms | Account maintenance | Estate settlement | Account funding and money movement

Top forms

Change of Beneficiary - NY (38120)
Change of Ownership - NY (38105)
Insurance & Annuity Death Claim Statement - NY (38111)
Outgoing Tax Qualified Annuity Transfer/Rollover - NY (13065)
Outgoing Non-Qualified 1035 Exchange - NY (138066)

Account maintenance

Change of Ownership/Annuitant - for RiverSource Life Insurance Co. of NY
Release of Collateral assignment NY (38107)

Estate settlement

Insurance and Annuity Death Claim Statement for RiverSource Life Insurance Co. of NY
RiverSource Death Claim Cover Sheet

Account funding and money movement

Outgoing Annuity Tax Qualified Transfer or Direct Rollover from RiverSource Life Insurance Co. of New York
Outgoing Non-Qualified 1035 Exchange from RiverSource Life Insurance Co. of New York
Privileged Asset Annuity Change of Ownership Form - New York
Privileged Asset Annuity Change of Beneficiary Form - New York
Privileged Asset Annuity Withdrawal Request Form - New York

Topics: Top forms | Contract maintenance | New accounts and additional purchases | Withdrawals

Top forms

Customer Service Request - NY
Death Claim Statement - NY
Portfolio Stabilizer Fund Election - NY
Telephone, Electronics and Change Instructions Authorization - NY
Third Party Consent - NY
Transfer Rollover Exchange - Outgoing-NY

Contract maintenance

Agent, client, and contract-specific maintenance forms

Agent specific

Agent Appointment Form
NY - Agent of Record Change

Client specific

Telephone, Electronic and Change Instructions Authorization
By Phone: 800.862.7919
Third Party Consent
By Phone: 800.862.7919

Contract specific

Annuitization Start Date Postponement Request
NY - Customer Service Requests
Available Online
By Phone: 800.504.0469 (address changes only)
NY - Investment Options Form for contracts purchased on or before 4/30/2007
Available Online
By Phone: 800.504.0469
NY - Investment Options form for contracts sold on or after 5/1/2007
Available Online
By Phone: 800.504.0469
NY - Non-Natural Ownership
NY - Portfolio Stabilizer fund Election Form
By Phone: 800.333.3437
NY - Telephone Transaction Authorization
NY - Transfer of Ownership
NY - Trustee Certificate

New accounts and additional purchases

Funding, purchase and other required forms

Funding

NY-Additional Payment (Add On) Receipt
IRA to Roth Conversion - In House
NY - Transfer Roll-over Exchange - Incoming

State specific required forms

NY - Definition of Replacement
NY - Important Notice Regarding Replacements
NY - 403(b) Information Sharing Agreement

Withdrawals

RMD, partial/full surrender, death claims and other withdrawal-related forms

Additional forms

NY - Statement of Disability

Death claims

NY - Death Claim Statement
NY - Death Claim Deferral Request

Divorce

NY - Annuity Divorce Surrender Form
By Phone: 800.504.0469

IRA/Qualified plans

NY - Required Minimum Distribution Request
Available Online
By Phone: 800.504.0469
NY - Transfer Roll-over Exchange - Outgoing
NY - 403(b) Distribution

Partial/Full surrenders

NY - Substantially Equal Periodic Payment Withdrawal Request

Topics: Top forms | All death claim forms

Top forms

Insurance and Annuity Death Claim Statement
Annuitization Request for Death Claims
Insurance and Annuity Change of Ownership Due to Death

All Death Claim Forms

Insurance and Annuity Death Claim Statement
Annuitization Request for Death Claims
Insurance and Annuity Change of Ownership Due to Death
RiverSource Beneficiary(ies) Identification and Location Assistance Form
Spousal Continuation of Death Riders Selection
Claim to Defer Payment of Annuity Death Benefit Proceeds
Release of Collateral Assignment of Life Insurance and Annuity for Death Claim Proceeds
RiverSource Death Claim Cover Sheet

Topics: Top forms

Top forms

Death Claim Statement
Claim to Defer Payment of Annuity Death Benefit Proceeds
Investment Options Form for Variable Annuities Sold before 4/30/2007
Investment Options Form for Variable Annuities Sold on or after 5/1/2007
Outgoing Annuity Tax-Free Transfer/Rollover/Exchange Form
Preference Beneficiary Affidavit NY OD
Release for Collateral Assignment
Required Minimum Distribution Request
Third Party Consent
Trustee Certificate

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