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Annuity Systematic Withdrawal Form

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This is the Annuity Systematic Withdrawal Form. If needed, please complete and submit the form.

Annuity Systematic Withdrawal Form

Before completing this form, please know:

  • Pacific Guardian Life does not allow transfers between tax qualified to accounts. If requested, the default action will be to send a check to the owner at the address of record.
  • You can fulfill your Required Minimum Distribution (RMD) through other tax qualified accounts you may have.
  • To make a one-time withdrawal from your annuity, please complete a Full or Partial Surrender Request form.
  • Systematic withdrawal arrangements of $2,500 and greater will require a notarized signature if not submitted to and signed by your servicing agent. Submissions directly made to a PGL office in person with proof of identification will not require notary.


Using a blue or black ink pen

Submit in 1 of 3 Ways

Email: [email protected]

Fax: 1 (800) 946-1295

or Mail:
Pacific Guardian Life
Attn: Client Relations Department
1440 Kapiolani Blvd.,
Suite 1700
Honolulu, HI 96814