Yes! You can use AI to fill out Fidelity Growth and Guaranteed Income Partial Withdrawal/Full Surrender Form

This form is used by owners of a Fidelity Growth and Guaranteed Income contract to request either a partial withdrawal of funds or a full surrender of their annuity. It allows the contract owner to specify the amount, provide tax withholding instructions, and direct how the payment should be received. Today, this form can be filled out quickly and accurately using AI-powered services like Instafill.ai, which can also convert non-fillable PDF versions into interactive fillable forms.
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Form specifications

Form name: Fidelity Growth and Guaranteed Income Partial Withdrawal/Full Surrender Form
Number of pages: 1
Language: English
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How to Fill Out Fidelity Partial Withdrawal/Full Surrender Form Online for Free in 2026

Are you looking to fill out a FIDELITY PARTIAL WITHDRAWAL/FULL SURRENDER FORM form online quickly and accurately? Instafill.ai offers the #1 AI-powered PDF filling software of 2026, allowing you to complete your FIDELITY PARTIAL WITHDRAWAL/FULL SURRENDER FORM form in just 37 seconds or less.
Follow these steps to fill out your FIDELITY PARTIAL WITHDRAWAL/FULL SURRENDER FORM form online using Instafill.ai:
  1. 1 Navigate to Instafill.ai and upload or select the Fidelity Partial Withdrawal/Full Surrender Form.
  2. 2 Use the AI assistant to accurately fill in your contract owner information, including name, contract number, and phone number in Section 1.
  3. 3 Choose your request type: either a partial withdrawal in Section 2, specifying the amount and source, or a full surrender in Section 3.
  4. 4 Complete Section 4 to provide your federal income tax withholding instructions for the distribution.
  5. 5 Indicate your preferred payment method in Section 5, such as a check to your address of record or an electronic funds transfer (EFT).
  6. 6 Carefully review all the information you've entered for accuracy before proceeding.
  7. 7 Electronically sign the form in Section 6. The system will alert you if a signature guarantee is required based on your request, which must be obtained separately before mailing the form.

Our AI-powered system ensures each field is filled out correctly, reducing errors and saving you time.

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Frequently Asked Questions About Form Fidelity Partial Withdrawal/Full Surrender Form

This form is used to request either a partial withdrawal of funds or a full surrender (cancellation) of your Fidelity Growth and Guaranteed Income annuity contract.

The owner(s) of a Fidelity Growth and Guaranteed Income annuity contract who wish to access their funds should complete this form.

A partial withdrawal allows you to take out some money while keeping your contract active. A full surrender terminates your contract completely, and you receive the entire cash value, minus any applicable fees and taxes.

If you do not make a selection for tax withholding, Fidelity will automatically deduct 10% for Federal Income Tax from the taxable portion of your distribution.

You must mail the completed and signed form to the P.O. Box address provided at the bottom of the form. Please note that faxes are not accepted.

Yes, taxable amounts withdrawn before you reach age 59 ½ may be subject to a 10% IRS penalty. Withdrawals may also reduce your guaranteed withdrawal benefit (GWB) and be subject to a surrender fee.

You can choose to receive a check by mail, have the funds transferred electronically (EFT) to your bank on record, or transfer the proceeds to another non-retirement Fidelity account.

A Signature Guarantee protects against fraud and is required for withdrawals over $100,000, payments to a third party, or payments sent to an address not on record. It is different from a notarization and can be obtained from most banks or brokerage firms.

Requesting a partial withdrawal with this form will terminate your active SWP. You will need to reinstate it during the next contract year if you wish for it to continue.

Yes, you should either enclose the original contract with the form or, if it has been lost or destroyed, check the box in Section 3 to certify this.

Yes, services like Instafill.ai use AI to accurately auto-fill form fields with your information, which can save you time and help reduce errors.

You can use a service like Instafill.ai to complete this form online. Simply upload the PDF, and the tool will make the fields interactive for you to fill out and sign electronically.

If you have a non-fillable PDF, you can upload it to a platform like Instafill.ai. The service can convert flat PDFs into interactive, fillable forms that you can easily complete on your computer.

If you have questions, you can call the Annuity Service Center at 800-634-9361 from Monday through Friday, 8 a.m. to 8 p.m. Eastern Time.

Compliance Fidelity Partial Withdrawal/Full Surrender Form
Validation Checks by Instafill.ai

1
Exclusive Withdrawal or Surrender Request
Validates that the user has completed either Section 2 for a partial withdrawal or Section 3 for a full surrender, but not both. This is crucial for preventing ambiguous or conflicting instructions that would require manual intervention to resolve. If both sections are filled, the form submission should be rejected with an error message prompting the user to choose only one action.
2
Contract Number and Owner Verification
Ensures the provided Contract Number exists, is active, and that the Owner's Name in Section 1 matches the primary owner on record for that contract. This is a fundamental security check to prevent unauthorized access to or transactions on an annuity. A mismatch would block the request and may trigger a fraud alert.
3
Partial Withdrawal Minimum Amount
Checks that if a 'Partial Withdrawal - Gross' or 'Partial Withdrawal - Net Charges' is requested, the specified dollar amount is a numeric value greater than or equal to the stated $50 minimum. This rule enforces the contract's terms and prevents the processing of insignificant or invalid transaction amounts. Requests below the minimum will be rejected, requiring the user to correct the amount.
4
Partial Withdrawal Option Selection
Verifies that in Section 2, exactly one withdrawal option ('Gross', 'Net', or 'Annual Maximum GWB') has been selected. If a gross or net amount is chosen, this check also ensures a corresponding dollar value has been entered. This prevents incomplete requests and ensures the withdrawal calculation method is clearly defined.
5
Full Surrender Certification Requirement
If a full surrender is requested in Section 3, this check ensures one of the two certification boxes regarding the original contract's status (enclosed or lost/destroyed) is checked. This certification is a required part of the legal process for closing the contract. An incomplete certification would prevent the surrender from being processed.
6
Required Tax Withholding Election
Verifies that a mandatory choice has been made in Section 4 regarding federal tax withholding. The user must explicitly select either to withhold a specific percentage or not to withhold taxes at all. This ensures compliance and clarity on tax handling, preventing the system from using a default that the client may not want.
7
Valid Tax Withholding Percentage
If the user elects to have taxes withheld, this validation confirms that the provided percentage is a valid, positive number within a logical range (e.g., 0.01-100). This prevents data entry errors, such as non-numeric characters or out-of-range values, which would make the tax calculation impossible. An invalid entry would require correction before the form can be processed.
8
Singular Payment Method Selection
Confirms that the user has selected exactly one payment method in Section 5 for receiving the proceeds. This prevents ambiguity in payment delivery, which could lead to delays or funds being sent to the wrong destination. The form should be rejected if zero or more than one option is selected.
9
Conditional Third-Party Payee Information
If the user selects the option to make a check payable to a third party or mail it to an alternate address, this check ensures the 'Payee' and 'Mail check to' fields are completed. This is necessary to correctly issue and deliver the payment as requested. Failure to provide this information would make the request impossible to fulfill.
10
Conditional Fidelity Account Number
If the payment option 'Transfer the proceeds to the following Non-Retirement Fidelity Account' is selected, this validation ensures the 'Account Number' field is filled and matches a valid Fidelity account format. This check is essential for the successful electronic transfer of funds. An invalid or missing number would cause the transfer to fail.
11
Required Owner Signature and Date
Validates that the primary owner has signed and dated the form in Section 6. A signature legally authorizes the transaction, and the date establishes when the authorization was given. A missing signature or date invalidates the entire request, making it legally non-binding and unprocessable.
12
Conditional Joint Owner Signature
Checks if a joint owner is listed on the contract and, if so, ensures their signature and date are also present in Section 6. For jointly owned contracts, authorization from all owners is typically required to process financial transactions. A missing joint signature would halt the request until all required authorizations are obtained.
13
Signature Guarantee Requirement Logic
This complex validation determines if a Signature Guarantee is mandatory by checking against several high-risk conditions listed in Section 6, such as withdrawals over $100,000 or payments to third parties. This is a critical fraud prevention measure that protects both the client and the company from unauthorized large-sum transactions. If the conditions are met, the form is flagged as incomplete until a valid guarantee is provided.
14
Valid Phone Number Format
Ensures the phone number provided in Section 1 conforms to a standard format (e.g., 10 digits, possibly with hyphens or parentheses). This is important for ensuring the contact information is usable if the processing agent needs to contact the owner to clarify any details. An invalid format would prompt the user for correction.

Common Mistakes in Completing Fidelity Partial Withdrawal/Full Surrender Form

Failing to Obtain a Signature Guarantee When Required

Users often misunderstand or overlook the Signature Guarantee requirement, mistaking it for a notary public stamp. This form requires a Signature Guarantee for withdrawals over $100,000, payments to third parties, or payments to a new address. Submitting without the correct stamp from an eligible financial institution will lead to immediate rejection and significant processing delays. To avoid this, carefully review the criteria in Section 6 and visit a bank or broker to obtain the guarantee before mailing the form.

Missing Joint Owner's Signature

On jointly owned contracts, it is common for only one owner to sign the form. The instructions in Section 6 clearly state that signatures of all owners are required in every case. An application with a missing signature is considered incomplete and will be returned, delaying the withdrawal or surrender process. Always ensure all individuals listed as owners on the contract have signed and dated the form in the designated spaces.

Confusing 'Gross' and 'Net' Partial Withdrawals

In Section 2, people often misunderstand the difference between a 'Gross' and 'Net' withdrawal. Requesting a 'Gross' amount means taxes and fees will be deducted from that amount, resulting in a smaller check. Requesting a 'Net' amount means the firm will withdraw enough to cover the requested amount plus any fees, so the check matches the request. This confusion can lead to receiving an unexpected payment amount. Carefully read the descriptions to ensure the withdrawal meets your financial needs.

Incomplete Tax Withholding Instructions

A frequent error in Section 4 is checking the box 'I WANT Federal Income Tax withheld' but failing to write in a specific percentage. This ambiguity forces the processing agent to either use the 10% default or return the form for clarification, causing delays. To prevent this, if you elect to have taxes withheld, always specify a whole number percentage in the space provided. If you do not want taxes withheld, be sure to check the 'I DO NOT want' box.

Submitting Contradictory Requests

Applicants sometimes fill out both Section 2 for a partial withdrawal and Section 3 for a full surrender. The form's instructions direct the user to fill out one or the other, not both. Submitting a form with conflicting instructions makes the user's intent unclear and will halt the processing of the request until clarification is obtained. Decide on one course of action and complete only the relevant section to ensure your request is processed correctly.

Incorrect or Incomplete Contract Number

The contract number is the primary identifier for the account, and data entry errors like transposing digits or omitting a number are common. An incorrect contract number in Section 1 will prevent Fidelity from locating the account, causing the request to be rejected. Double-check the contract number against your account statement to ensure it is completely accurate before submitting. AI-powered tools like Instafill.ai can help prevent this by saving and accurately populating such critical information.

Mailing the Form to the Wrong Address

The form lists two different P.O. Box addresses at the bottom: one for New York residents and one for all other states. Sending the form to the incorrect address can add significant delays as it will need to be rerouted internally. To avoid this, New York residents must use the specific 'Empire Fidelity' P.O. Box, while all other residents should use the standard 'Fidelity Investments' P.O. Box.

Attempting to Fax the Form

Despite advances in technology, many people still attempt to fax forms out of habit. The instructions at the top of this form explicitly state 'Faxes are not accepted.' Any request submitted via fax will be disregarded, and the user will not receive their funds or any notification of the failed submission. The only valid submission method is mailing the physical form to the correct address. Since this is a non-fillable PDF, tools like Instafill.ai can convert it into a fillable version for clean, legible printing before mailing.

Invalid Payment Instructions

In Section 5, users may request a payment method that triggers an additional requirement they fail to meet. For example, requesting a check be mailed to an address other than the one on record requires a Signature Guarantee. Failing to provide that guarantee will cause the request to be rejected. To avoid this, either use a payment method that doesn't require a guarantee (like a check to the address of record) or ensure you complete all associated requirements for your chosen method.

Mismatch Between Total and Itemized Withdrawal Amounts

When requesting a partial withdrawal from specific funds in Section 2, users sometimes list individual fund amounts that do not add up to the 'Total Amount' they entered. This discrepancy creates ambiguity and requires the service center to contact the owner for clarification, delaying the transaction. If you choose to specify withdrawals from particular funds, always double-check your math to ensure the sum of the parts equals the requested total.
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