Required Minimum Distribution Election Form - Penn Mutual
Required Minimum Distribution Election Form - Penn Mutual
Required Minimum Distribution Election Form - Penn Mutual
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7. Signatures<br />
There may be contractual charges for taking a withdrawal from your annuity contract. If you have any<br />
questions, please consult your contract prospectus, your financial professional, or one of our Customer<br />
Service Representatives.<br />
• I represent that no bankruptcy or insolvency proceeding is pending with respect to me.<br />
• My signature below indicates I have read and understand the preceding information and elect to proceed<br />
with this transaction.<br />
Contract Owner Signature<br />
/ /<br />
Date (mm/dd/yyyy)<br />
Contract Co-Owner Signature (if applicable)<br />
/ /<br />
Date (mm/dd/yyyy)<br />
Please return form to <strong>Penn</strong> <strong>Mutual</strong> Life Insurance Company, Annuity Services<br />
P.O. Box 178, Philadelphia, PA 19105-0178, or fax to 215-956-7699<br />
If you have questions please call Customer Service, Monday through Friday at 1-800-523-0650<br />
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