Page 1 of 4 Important Information About Transferring Ownership Designating Your Beneficiary An Ownership Transfer does not automatically change the beneficiary. Upon completion of this transfer, the new owner will receive the option to name new beneficiaries. If a change in beneficiary is desired, a Beneficiary Change form must be submitted. Tax Disclaimer There may be tax implications associated with this transfer of ownership. You should consult a tax advisor regarding your potential liability for taxation. Trust Signature Requirement If the current owner and/or new owner is a trust with multiple trustees named, each trustee must sign Section F or Section G, as applicable. If any trustee cannot sign along with the other trustees, a separate notarized signature page can be added. Joint Ownership Please review your life insurance policy or non-qualified annuity contract to verify joint ownership is available. Teachers Insurance and Annuity Association of America ( TIAA ) or TIAA-CREF Life Insurance Company ( TIAA-CREF Life ) will not process your transfer of ownership request if your policy or annuity contract does not contain the joint ownership provision. Please be sure to consult with your attorney about the legal ramification of co-owning property with one or more individuals or business entities. Notwithstanding any statement in this form to the contrary, all of the undersigned individuals are considered owners of the underlying policy or annuity contract. Disclaimer: Increasing or decreasing the number of owners listed on a life insurance policy or non-qualified annuity contract after it has already been issued may result in income and/or gift taxes. TIAA or TIAA-CREF Life is not responsible for the legal implications of your ownership arrangement. Agreement The owner(s) acknowledge that all administrative rights, privileges and responsibilities incident to the management of the policy or annuity contract be vested in one person (the Primary Owner ). Below is a non-cumulative list of policy or annuity contract management rights and privileges that the Primary Owner is vested with. In the event that the Primary Owner predeceases the insured or annuitant, all such rights and privileges will transfer automatically to the next owner listed on page 2, in successive order. Rights vested in the Primary Owner 1. The right to access policy or annuity contract information online; 2. The right to change policy or annuity contract investments; 3. The right to allocate policy or annuity contract cash values between the various investment choices; 4. The right to receive policy or annuity contract statements and all other communications; 5. The responsibility for paying policy premiums; 6. The responsibility to receive lapse notices and general information from TIAA and TIAA-CREF Life and then to communicate that information in a timely manner to the other owners; and 7. The responsibility of any tax reporting forms, along with appropriate tax withholding. Rights retained by all Owners The following list of rights and privileges are retained by all owners (i.e., the Primary Owner and non-primary Owner(s)). All owners must approve the following transactions: 1. The right to surrender the policy or annuity contract; 2. The right to assign, endorse, exchange, or transfer the ownership of the policy or annuity contract; 3. The right to change the beneficiaries; and 4. The right to take loans or withdrawals from the policy or annuity contract. If you have any questions about completing the Transfer of Ownership form or if we can help you in any way, please call the TIAA-CREF Insurance Service Center at 877 694-0305, Monday Friday, 8 a.m. 6 p.m. (ET). TI MT F7730 (09/12)
Page 2 of 4 Request to Transfer Ownership Please Print in Black or Blue Ink I hereby transfer ownership of Policy or Annuity Contract Number to the New Owner(s) designated below. I understand that the New Owner(s) will have all the rights under the Policy/Annuity Contract. I also understand that this ownership change will be effective when the required documentation is received in good order. Section A: Insured, Annuitant and Current Owner(s) 1. Insured or Annuitant s Full Legal Name (Title, First, Middle, Last, Suffix): 2. Current Owner s Full Legal Name (if different than Insured or Annuitant) (Title, First, Middle, Last, Suffix): 3. Current Joint Owner s Full Legal Name (complete this section for additional owners) (Title, First, Middle, Last, Suffix): 4. Current Trust Name (if applicable): Section B: Primary New Owner (Individual) The Primary owner is the only person who TIAA or TIAA-CREF Life will provide with administrative rights such as: online account access; the right to change investments; the right to allocate cash values between the various investment choices; and the right to receive statements, notices, and all other communications. 1. Full Legal Name (Title, First, Middle, Last, Suffix): 2. Relationship to Current Owner: 3. Taxpayer I.D. or Social Security Number: 4. of Birth: 5. Email Address: 6. Telephone No. 7. Address (Number and Street): Apt./Suite/Floor: Section C: New Joint Owner (Individual) Please review your life insurance policy or non-qualified annuity contract to verify joint ownership is available. TIAA or TIAA-CREF Life will not process your transfer of ownership request if your policy or annuity contract does not contain the joint ownership provision. 1. Full Legal Name (Title, First, Middle, Last, Suffix): 2. Relationship to Current Owner: 3. Taxpayer I.D. or Social Security Number: 4. of Birth: 5. Email Address: 6. Telephone No. 7. Address (Number and Street): Apt./Suite/Floor: Section D: New Owner Trust Name (if applicable) Note: When a transfer of ownership is made to a trust, in general, the trust should also be named as beneficiary. Please confer with your tax and/or legal advisor. 1. Name of Trust: 2. of Trust: 3. New Trust Taxpayer I.D.: 4. Trust Address (Number and Street): Apt./Suite/Floor: Section E: New Owner Corporation Name (if applicable) Note: When a transfer of ownership is made to a corporation, in general, the corporation should also be named as beneficiary. Please confer with your tax and/or legal advisor. 1. Name of Corporation: 2. of Incorporation: 3. Corporation Taxpayer I.D.: 4. Name of Corporate Representative: 5. Telephone No.: 6. Corporation Address (Number and Street): Apt./Suite/Floor: TI MT F7730 (09/12)
Page 3 of 4 We, the undersigned, fully understand that Transfer of Ownership shall only be complete upon receipt and acceptance, by Teachers Insurance and Annuity Association of America (TIAA) or TIAA-CREF Life Insurance Company (TIAA-CREF Life), of this properly completed Transfer Form. Section F: Current Owner(s) Notary Section I (We) hereby transfer and set over to the New Owner designated above, his or her executors, administrators or assigns, the policy or annuity contract designated above, together with all rights, title and interest therein. d at State of this day of Signature of Owner... Signature of Joint Owner.. Signature of Collateral Assignee.. Signature of Irrevocable Beneficiary Signature of Spouse/Legally recognized domestic partner (required if spouse/domestic partner currently resides or formerly resided in one of the community property states listed below). AZ, CA, ID, LA, NV, NM, TX, WA, WI). Signature(s) of Corporate Representative, Partner or Trustee: State of: County of: SS: ACKNOWLEDGMENT On this day of,, before me personally appeared, to me known and known to be the individual(s) described in and who executed the foregoing transfer of ownership and acknowledged to me that he/she/they executed the same. Seal Notary Public (Signature) My commission expires TI MT F7730 (09/12)
Page 4 of 4 Section G: New Owner(s) Notary Section I (We) understand the terms of this transfer, and I (We) agree to accept all rights, title, interest, and obligations of this policy or annuity contract. d at State of This day of Signature of New Owner... Signature of New Joint Owner.. Signature(s) of New Corporate Representative, Partner or Trustee _ State of County of SS: ACKNOWLEDGMENT On this day of,, before me personally appeared, to me known and known to be the individual(s) described in and who executed the foregoing transfer of ownership and acknowledged to me that he/she/they executed the same. Seal Notary Public (Signature) My commission expires (If new owner is a Trust, please complete the enclosed Trustee Declaration of Authority or Trust Declaration and Certification form.) For Company Use Only ACCEPTANCE ACKNOWLEDGMENT TIAA/TIAA-CREF Life Registrar: : SEND COMPLETED FORM TO: TIAA-CREF, INSURANCE SERVICE CENTER, P.O. BOX 724508, ATLANTA, GA 31139 TI MT F7730 (09/12)
Page 1 of 1 Lost Contract Affidavit Please Print in Black or Blue Ink Contract Number(s) I, (name), certify that each contract listed above by number is not in my possession and I believe that such contract has been either lost or destroyed. To the best of my knowledge and belief, no other person is in possession of these contracts. The purpose of this declaration is to request Teachers Insurance and Annuity Association of America (TIAA) and/or TIAA-CREF Life Insurance Company (TIAA-CREF Life) to accept this declaration instead of the submission of the contracts in connection with the application for benefit payments from these lost contracts. In return, I agree for myself, my heirs, executors, administrators, or assigns to warrant and forever defend TIAA and/or TIAA-CREF Life against any claim resulting from these lost contracts. I also agree to indemnify and hold TIAA and/or TIAA-CREF Life harmless from any claims, demands, suits, liabilities, and any damages to which it may be subject by reason of or in consequence of being obliged to make any payment under these lost contracts. I further agree that these lost contracts shall be of no further value and I agree to return them, if and when found, so that they may be destroyed. I certify that, unless specifically described below, there have been no pledges, transfers, or assignments of these lost contracts. Signature State of County of SS: Subscribed and sworn to before me this (date) Notary Public Signature* *Notary public must include notarial number and the Notarial Number Expiration date appointment expires with this signature. SEND COMPLETED FORM TO: TIAA-CREF, INSURANCE SERVICE CENTER, P.O. BOX 724508, ATLANTA, GA 31139 TI IL F4204 (09/12)
This page has been intentionally left blank.
Trustee Declaration of Authority Form Page 1 of 2 Policy/File Number: Please Print in Black or Blue Ink This form is to be completed in each case in which a trust will own a life insurance policy. Please print clearly. Please attach additional sheets, if needed. Each sheet must be signed and dated by all parties. You do not have to send a copy of your trust document or amendments to the Trust document. However, we reserve the right to request a copy, if needed. Section A: Trust Information 1. Name of Trust: 2. the Trust was signed/created (mm/dd/yyyy): 3. Trust Taxpayer I.D.: 4. State law that governs the trust (this is typically the state in which the trust was created): 5. Trust Correspondence Mailing Address (Provide the address all correspondence should be sent to): Section B: Insured(s) Information 1. Insured s Full Legal Name (First, Middle, Last, Suffix): 2. Insured s Full Legal Name (First, Middle, Last, Suffix): Section C: Trustee(s) Information All new Trustees being added must provide this information. As required by federal law Teachers Insurance and Annuity Association of America (TIAA) or TIAA-CREF Life Insurance Company (TIAA-CREF Life) will use the information provided below to verify your identity. (Note: if additional space is needed, you may attach another page.) Primary Trustee The Primary Trustee is the only person who TIAA or TIAA CREF Life will provide with administrative rights such as: online account access; the right to change policy investments; and the right to allocate policy cash values between the various investment choices. All other non-administrative decisions require sign-off by all trustees. 1. Full Legal Name (First, Middle, Last, Suffix): 2. Taxpayer I.D. or Social Security Number: 3. of Birth: 4. Email Address: 5. Telephone No.: 6. Address (Number and Street): Apt./Suite/Floor: Trustee 1. Full Legal Name (First, Middle, Last, Suffix): 2. Taxpayer I.D. or Social Security Number: 3. of Birth: 4. Email Address: 5. Telephone No.: 6. Address (Number and Street): Apt./Suite/Floor: Trustee 1. Full Legal Name (First, Middle, Last, Suffix): 2. Taxpayer I.D. or Social Security Number: 3. of Birth: 4. Email Address: 5. Telephone No.: 6. Address (Number and Street): Apt./Suite/Floor: TI ITC POS_F1007Life (09/12)
Page 2 of 2 Section C: Trustee(s) Information (Cont d) Trustee 1. Full Legal Name (First, Middle, Last, Suffix): 2. Taxpayer I.D. or Social Security Number: 3. of Birth: 4. Email Address: 5. Telephone No.: 6. Address (Number and Street): Apt./Suite/Floor: The undersigned trustee(s) (the Trustees ) represent and declare that (1) The above-named trust exists and all legal formalities for its establishment under applicable state law have been met, and (2) The Trustees are authorized within the trust to purchase life insurance. The Trustees acknowledge that TIAA or TIAA-CREF Life will recognize the trust as the sole owner of the life insurance policy and that TIAA or TIAA-CREF Life may rely solely on the signature of the Primary Trustee for exercise of all policy administrative rights or options including, but not limited to, any right or option to change the policy investment choices, online policy access, etc. The exercise of all non-administrative rights or options such as the surrender of the policy in whole or in part, policy loans, the assignment of the policy, ownership transfer, etc., will require the signatures of all trustees. The Trustees declare that all current and future trustees are bound by this declaration form, and that TIAA or TIAA-CREF Life may rely on and act at the direction of the Trustees, until TIAA or TIAA-CREF Life receives written notification at its administrative Office, P.O. Box 724508, Atlanta, GA 31139, of a change in the Trustees, change of certain trustee authority or a revocation/termination of the trust. The Trustees agree to make this notification within a reasonable time after such a change and to provide TIAA or TIAA-CREF Life with any other reasonable information upon request. Furthermore, by signing below you are certifying to TIAA or TIAA-CREF Life that (i) you are authorized to act on behalf of the trust, (ii) the information you have supplied above is accurate, (iii) you agree to indemnify and hold TIAA and TIAA-CREF Life harmless for reliance upon this declaration form until such time as further written notification is received from you, (iv) you will notify TIAA or TIAA-CREF Life of any change in Trustees or change in trustee authority, (v) the Primary Trustee named in section C of page 1 will be the only trustee with access to account information online and authorized to request account modifications that are administrative in nature. Section D: Trustee(s) Signature Please have all current acting trustees, with authority to exercise life insurance policy rights, sign and date this form below: X Primary Trustee Signature X Trustee Signature X Trustee Signature X Trustee Signature If corporate trustee, please include official title here: SEND COMPLETED FORM TO: TIAA-CREF, INSURANCE SERVICE CENTER, P.O. BOX 724508, ATLANTA, GA 31139 TI ITC POS_F1007Life (09/12)