NSS Forms and Resources

The National Slovak Society of the United States | Fraternal Life Insurance Since 1890
Annuities FormsLife Insurance Forms

NEW Federal Tax Withholding Requirements for all Disbursements

As of January 2023, the IRS is requiring Form W-4P, Withholding Certificate for Periodic Pension or Annuity Payments and/or Form W-4R for Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions to be completed. These forms are REQUIRED for all disbursements, including life insurance and both tax qualified and nonqualified annuities.

See link to letter below for further information and instructions for filling out the new W-4P and W-4R forms.

Annuity Resources

NSS Life annuity applications must be viewed with a program called Adobe Acrobat Reader. If you aren’t sure that you have it, you may download it for free from the Adobe website. Using an iPhone? Please download the app using the iStore. If you are on an Android device, download the app via the apps store.

To download the correct form, please choose the state in which the applicant resides – we are only licensed to sell to residents of: AL, AZ, CA, CO, CT, FL, GA, IL, IN, KY, MD, MI, MN, NJ, NC, OH, PA, SC, TN, TX, VA, WV, and WI.

Direct State Download
(Click on a state name to download the application)
*Currently no new business being accepted

 

Annuity Form Download
(Click on a form name to download the form)

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NSS Life insurance applications and forms must be viewed with a program called Adobe Acrobat Reader. If you aren’t sure that you have it, you may download it for free from the Adobe website. Using an iPhone? Please download the app using the iStore. If you are on an Android device, download the app via the apps store.

To download the correct form, please choose the state in which the applicant resides – we are only licensed to sell to residents of: AL, AZ, CA, CO, CT, FL, GA, IL, IN, KY, MD, MI, MN, NJ, NC, OH, PA, SC, TN, TX, VA, WV, and WI.

State

FULL APPLICATION
(AGES 60 & OLDER OR
OVER $50,000)

SHORT APPLICATION
(UP TO $50,000)

Alabama
Arizona
California
Colorado
Connecticut
Florida*
Georgia
Illinois
Indiana
Kentucky
Maryland
Michigan
Minnesota
Missouri
New Jersey
North Carolina
Ohio
Pennsylvania
South Carolina
Tennessee
Texas
Virginia
West Virginia
Wisconsin