Log in
Claims Pay a bill

Nationwide annuity forms can be filled out and submitted online. You can also download, fill out and fax or email them to the address on the form.

Please note that some forms may request submission of additional documentation. There may also be the need to gather other email addresses for forms that require multiple e-signatures.

Beneficiary change form

Use this form to request a change to the beneficiary designation for your annuity. You may also update contingent beneficiaries.

Note: If you live in Massachusetts, you cannot submit this form online because a witness signature is required. Please download the form instead, fill out, and fax or mail to the address on the form.

Electronic funds transfer (EFT) authorization

Use this form to set up or make changes to recurring electronic funds transfers from your checking or savings account in order to make premium payments on your Nationwide ® policy or policies automatically.

Note: Do not use this form to take annuity withdrawals from your contract. Use this form to draft money from your bank account INTO your Nationwide annuity contract.
Want to submit your form online? Log in to your account.