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Inforce   Licensing   Contracting   Commissions Annuitizations   Claims   Inforce Form Number Form Name Description of Form ZA-8154 Collateral Assignment Form Use when assigning the contract to cover a loan (i.e. bank loan) ZA-8176 Pre-Authorized Checking Agreement Use when establishing an automatic premium withdrawal from a checking account. ZA-8623 Participant Loan Agreement Use to set up a loan. ZA-8635 Systematic Distribution Form Use to set-up an automatic distribution from an annuity. ZA-8641 Financial Transaction IRA/Non-Qualified Form Use when taking a partial or full withdrawal from an IRA or non-qualified annuity. ZA-8642 Financial Transaction 403(b)/TSA or 401(k) Form Use when taking a partial or full withdrawal from a 403(b)/TSA or 401(k) annuity. ZA-8656 Systematic Transfer Form Use when establishing a dollar cost averaging or asset rebalancing program. ZA-8658 Fund Transfer/Allocation Change Form Use when transferring existing funds or changing future allocations. ZA-6033 Telephone Transfer Authorization Use when authorizing transfers by the phone on your account. ZA-1025 Non-Financial Change Form Use when changing address, name, maturity date, beneficiaries or owners. ZA-1068 Trustee Certification Required with ZA-1025 if ownership is changing to a trust. ZA-1105 Disability Certification Use if exercising the Disability Rider. ZA-1329 Guaranteed Retirement Income Benefit (GRIB) Cancellation Form Use when canceling the GRIB benefit. ZA-1043 Required Distribution Election Form Use when taking distributions after age 73. ZA-2001 International Wire Transfer Authorization Form Use for Payments to Payees Living Abroad for Scudder Destinations Annuity contracts and Farmers VA I contracts. Top Licensing Form Number Form Name Description of Form ZA-8219 Representative Application Use when requesting appointment with Zurich American Life Insurance Company. ZA-1087 Agent of Record Change form Use to execute a Broker Dealer change. Top Contracting Form Number Form Name Description of Form ZA-8321 Net Compensation Amendment   ZA-8247 Broker/Dealer Commission Election Form   Top Commissions Form Number Form Name Description of Form ZA-COM-DD Commission Direct Deposit Request Form Optional.  Submit for firm to receive commissions via EFT to checking or savings account. Top Annuitizations Form Number Form Name Description of Form ZA-7008 Fixed Annuity Income Plan Option Form Use when requesting a fixed annuity income plan be established. ZA-9000 Guaranteed Retirement Income Benefit Annuity Income Option Form Use when electing the Guaranteed Retirement Income Benefit Option. ZA-9001 GRIB Commutable Annuitization Option Form Use when requesting commutation of existing payments under the terms of the Guaranteed Retirement Income Benefit Option. ZA-9003 GRIB - Helpful Hints Information regarding the Guaranteed Retirement Income Benefit process. ZA-2001 International Wire Transfer Authorization Form Use for Payments to Payees Living Abroad for Scudder Destinations Annuity contracts and Farmers VA I contracts. Top Claims Form Number Form Name Description of Form ZA-1004 Death Packet Form Use when requesting death benefit proceeds. ZA-2001 International Wire Transfer Authorization Form Use for Payments to Payees Living Abroad for Scudder Destinations Annuity contracts and Farmers VA I contracts. Top