Form #Form NameDescription
VL 18484Transfer-Rollover In For Use with VALIC Independent ChannelUsed exclusively by external broker-dealers to transfer-rollover in funds for ALL PLAN TYPES from a client account at another carrier to VALIC.
VL 26991Inside Edge Individual Fixed Annuity ApplicationInside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459.
VL 26991-FLInside Edge Individual Fixed Annuity Application - FLInside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 for FLorida only.
VL 26991-NJInside Edge Individual Fixed Annuity Application - NJInside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 for New Jersey only.
VL 26991-NYInside Edge Individual Fixed Annuity Application-NYInside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile.For use in New York only. Replaces VL 25459 NY only
VL 26991-VAInside Edge Individual Fixed Annuity Application - VAInside Edge Fixed Annuity Application must accompany the Inside Edge custodial application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459-VA.
VL 26991 (406)VALIC Fixed Annuity-406 ApplicationVALIC Fixed Annuity-406 application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 (406).
VL 26991-FL (406)VALIC Fixed Annuity-406 Application-FLVALIC Fixed Annuity-406 application. For use in Florida only. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459(406) in Florida Only
VL 26991-NJ (406)VALIC Fixed Annuity-406 Application - NJVALIC Fixed Annuity-406 application. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459(406) in New Jersey.
VL 26991-NY (406)VALIC Fixed Annuity-406 Application-NYVALIC Fixed Annuity-406 Allocation. For use in New York only. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459 NY only (406)
VL 26991-VA (406)VALIC Fixed Annuity-406 Application-VAVALIC Fixed Annuity-406 Allocation. For use in Virginia only. PDF includes Application, Owner Acknowledgement, Agent Access and Client Profile. Replaces VL 25459-VA (406).
SEE REPLACEMENT TABSee Replacement TabSee Replacement Tab for access to State Replacement Forms.
VL 259Fixed Annuity Notice Regarding Standards MediCal EligibilityRequired for all VALIC annuity products (fixed, variable, qualified and nonqualified ) being sold to clients who reside in CA and are 65 years of age or older if the product is being sold on the basis of its treatment under the CA Medi-Cal program.
VL 22107Inside Edge 401(a) Custodial Account EnrollmentInside Edge Mutual Fund Employee Enrollment form for 401(a) enrollment.
VL 23765-ICState of New York Compensation Disclosure - ICUsed when enrolling clients in Group or Individual Annuity products in the state of New York - informing the client regarding VALICs policy of compensating its insurance producers and their role in offering insurance products. Independent Channel.
VL 22583Investment Advisory Services Authorization FormRequired to establish Investment Advisory Services on a VALIC client account(s).
VL 28103Replacement Form for VirginiaUsed when replacing life insurance products, including annuities and with all new business in Virginia.
VL 14131Model Replacement FormUsed when replacing life insurance products, including annuities and with all new business in the following states. AL-AR-AK-AZ-CO-CT-HI-IA-KY-LA-MD-ME-MO-MS-MT-NC-NE-NH-NJ-NM-OH-OR-RI-SC-SD-TX-UT-VT-WI-WV. Replacement
VL 22305Agent Access Authorization FormUsed to grant account access to Agents as named by the client or to establish a Contact Center password on the clients account. PDF only.
VL 25190Record of ContribtuionUsed by the Independent Channel to transmit an additional contribution for a client and for providing the client with a receipt. Complete only as needed.
VL 25031Request to Transfer NQDA or Non-insurance Funds to VALICUsed exclusively by external broker-dealers to liquidate Nonqualified or Non-Insurance accounts and transfer funds to VALIC.
VL 23431Client ProfileUsed to establish Independent Channel accounts. Must be completed and submitted with every application, VALIC transfer, rollover, exchange, except VALIC group enrollments in a variable product. Distribute form copies as noted in the legend at bottom.
VL 22059Sale to Military Personnel DisclosureThis disclosure form is required if the client has answered YES to being an active duty service member of the United States Armed Forces for all individual non-qualified and IRA applications.
VL 22415Profile and Inside Edge Beneficiary Change FormUsed to submit beneficiary designations changes for Profile or Inside Edge Accounts only.
VL 23303Affidavit and Indemnification of Custodian for MinorsUsed to open an IRA-Roth IRA in the name of a Minor. Affiant agrees to indemnify VALIC, including its agents, employees, successors, and assigns from every claim, demand or suit brought against them.
VL 26470-AFlorida Annuity Suitability QuestionnaireRequired for all Florida transactions when purchasing a fixed annuity product regardless of how it is funded. Signature pages must be signed. Replaces VL 22982-A
VL 26470-BFlorida Disclosure - Comparison of Annuity ContractsRequired for all Florida transactions when purchasing an annuity product and the source of the money is another annuity. Signature pages must be signed. replaces VL 22982-B
VC 26126NAIC Buyers Guide for Deferred Annuities - Multi StatesUsed to assist clients in understanding Fixed and Fixed Index Annuities in the following states AL AK AR AZ CO FL GA HI IA ID KY ME MO MT ND NV NJ NM NC OH OK OR RI SC TX UT VT WI and WV. Also required in AL, CO, FL, GA, IA, KY, ME, MO, OH, RI, TX, WI, and WV for Variable Annuities. Must be provided to clients at time of application for the following plan types only IRA, Roth IRA, SEP, Simple IRA and NQDA. Use appropriate guide based on client's state of residence. New Hampshire requires the NAIC buyers guide effective 4/30/2018 with 60 day implementation extension period to 6/30/2018.