Service Forms

Use this form to set up a payment arrangement in which premiums are paid monthly by automatically deducting the money directly from your checking or savings account.

Call Us: 1-800-225-5695

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Change of Beneficiary Form

Use this form to change your beneficiary if your policy is a family plan or if it has rider insureds.

Call Us: 1-800-225-5695

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Transfer of Ownership / Designation of Successor Owner Form

Use this form to make the most standard transfer of ownership requests.

Call Us: 1-800-225-5695

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Transfer of Ownership Kit

Use this kit to transfer ownership, setup a Check-O-Matic arrangement to pay your premiums, and change your beneficiary.

Call Us: 1-800-225-5695

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Use this form to request a loan against the cash value of your policy, while still maintaining your insurance coverage.

Call Us: 1-800-225-5695

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Loan repayments via automatic payment arrangement

Use this form to set up a payment arrangement in which loan repayments are paid monthly by automatically deducting the money directly from your checking account.

Call Us: 1-800-225-5695

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Partial Withdrawal Request Form

Use this form to request a partial withdrawal from your Target, Universal, or Annuity policies.

Call Us: 1-800-225-5695

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Statement of Trust Form

Use this form to change the beneficiary or ownership of your policy to a Trust.

Call Us: 1-800-225-5695

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Dividend Withdrawal Form

Use this form to withdraw dividends from your policy.

Call Us: 1-800-225-5695

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Name Change Request Form

Use this form to process a change of Name on your policy.

Call Us: 1-800-225-5695

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

If you are a US person, use this form to: certify that the Taxpayer Identification Number (TIN) you are giving is correct (or you are waiting for a number to be issued); certify that you are not subject to backup withholding; or claim exemption from backup withholding if you are a U.S. exempt payee

IRS Form W-4P - Withholding Certificate for Pension or Annuity Payments

If you are a US person, use this form for all annuity contracts and annuity death claims.

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

IRS Form W-9 - Request for Taxpayer Identification Number and Certification

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

IRS Form W-8BEN - Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding (Individuals)

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Instructions for the Form W-8BEN

Instructions to complete the IRS Form W-8BEN.

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

IRS Form W-8BEN-E - Certificate of Status of Beneficial Owner for United States Tax Withholding and Reporting (Entities)

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Instructions for the Form W-8BEN- E

Instructions to complete the IRS Form W-8BEN-E.

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

IRS Form W-8ECI - Certificate of Foreign Person"s Claim

That Income Is Effectively Connected With the Conduct of a Trade or Business in the United States

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Instructions for the Form W- 8ECI

Instructions to complete the IRS Form W-8ECI.

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

IRS Form W-8EXP - Certificate of Foreign Government or Other Foreign Organization for United States Tax Withholding and Reporting

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Instructions for the Form W- 8EXP

Instructions to complete the IRS Form W-8EXP.

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

IRS Form W-8IMY - Certificate of Foreign Intermediary, Foreign Flow-Through Entity, or Certain U.S. Branches for United States Tax Withholding and Reporting

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313

Instructions for the Form W- 8IMY

Fax number: (800) 278-4117

Mailing address:
New York Life Insurance Company
Dallas Service Center
P.O. Box 130539
Dallas, TX 75313