Yes! You can use AI to fill out Fidelity Investments Withdrawal — One-Time
This form allows an annuity contract owner to make a one-time withdrawal of a specific amount or to surrender the entire contract value. It is essential for accessing funds from a Fidelity annuity and requires specifying withdrawal amounts, delivery methods, and tax withholding preferences. 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 Investments Withdrawal — One-Time |
| Number of pages: | 1 |
| Language: | English |
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Follow these steps to fill out your 1.812957.122 form online using Instafill.ai:
- 1 Navigate to Instafill.ai and upload the Fidelity Withdrawal — One-Time form or select it from their template library.
- 2 Provide your personal and contract information in Section 1, including the annuity contract number and owner details.
- 3 In Section 2 or 3, specify the withdrawal details, choosing whether to withdraw a partial amount or surrender the entire contract.
- 4 Select your preferred withdrawal method in Section 4, such as direct deposit to a Fidelity account, EFT to a bank, or a mailed check.
- 5 Complete Section 5 to indicate your federal and state tax withholding preferences for the withdrawal.
- 6 Review all the information populated by the AI for accuracy, then follow the form's instructions to provide an original ink signature in Section 6, obtaining a Medallion Signature Guarantee if required.
- 7 Mail the completed and signed form to the appropriate Fidelity Annuity Service Center address listed on the form.
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Frequently Asked Questions About Form 1.812957.122
This form is used to request a one-time withdrawal from your Fidelity Personal Retirement Annuity or Fidelity Retirement Reserves Annuity. You can use it for either a partial withdrawal or to surrender (close) the entire contract.
Any owner of a Fidelity annuity who wishes to make a single lump-sum withdrawal needs to complete this form. It is not intended for setting up recurring or systematic payments.
You will need your annuity contract number, personal contact information, and details for your withdrawal method, such as a bank or Fidelity account number. Your contract number can be found on a recent statement or on Fidelity.com.
A partial withdrawal takes out a portion of your funds while keeping the contract active with a minimum required balance. Surrendering your contract means you are withdrawing the entire cash value, which will then cancel the contract.
No, you can elect not to have federal or state taxes withheld, but you may be responsible for estimated tax payments and potential penalties. The default federal withholding rate is 10%, but you can specify a different rate in Section 5.
A Medallion Signature Guarantee is a special signature verification from a financial institution that protects against fraud. It is required if your withdrawal is over $100,000, being sent to someone other than the contract owner, or over $30,000 and your address was recently changed.
No, the form explicitly requires an original 'ink' signature from all contract owners in Section 6. Copies or digital signatures are not accepted for processing.
You must mail the entire completed and signed form to the Annuity Service Center address listed on the form. Different P.O. boxes are provided for regular mail depending on your state, as well as an address for overnight mail.
No, the instructions state that you must use a separate withdrawal form for each individual annuity contract you wish to take a withdrawal from.
In Section 4, you can choose to have the funds deposited to a Fidelity account, sent via EFT to your bank, or mailed as a check. If you don't make a selection, a check will be mailed to the address of record by default.
Yes, services like Instafill.ai use AI to help you accurately auto-fill form fields, which can save time and reduce errors. This ensures all necessary information is entered correctly before you print the form for your signature.
You can use a service like Instafill.ai to complete the form online. Simply upload the PDF, and the tool will make the fields interactive for you to type in your information, which you can then download and print for signing.
If you have a non-fillable or 'flat' PDF, you can upload it to a service like Instafill.ai. The platform can convert it into an interactive, fillable form that you can complete on your screen.
Compliance 1.812957.122
Validation Checks by Instafill.ai
1
Ensures Contract Number is Provided
This check verifies that the 'Annuity Contract Number' field in Section 1 is not empty. The contract number is the primary identifier for the account being acted upon, and without it, the withdrawal request cannot be processed. If this field is left blank, the form submission will be rejected with an error message prompting the user to enter their contract number.
2
Validates Mutually Exclusive Withdrawal Type Selection
This validation ensures that the user has provided details for either a partial withdrawal in Section 2 or a full surrender in Section 3, but not both. These actions are mutually exclusive. If both sections contain information, or if neither is completed, the form is considered invalid and the user will be prompted to choose only one type of withdrawal.
3
Verifies Partial Withdrawal Minimum Amount
If the user selects to withdraw a specific dollar amount in Section 2, this check confirms the entered value is numeric and meets the $500 minimum requirement. This rule prevents requests for trivial amounts that may be administratively burdensome or against policy. A value less than $500 will trigger an error, asking the user to correct the amount or choose a different withdrawal option.
4
Enforces Single Withdrawal Method Selection
This check validates that exactly one withdrawal method is chosen in Section 4. The form provides four distinct options for receiving funds, and the system can only process one. If the user selects more than one method or fails to select any, the submission will be halted until a single, valid choice is made.
5
Requires Completeness for Alternate Payee Details
When the 'Check paid to an alternate payee' option is selected in Section 4, this validation ensures that the 'Alternate Payee Name', 'Address', 'City', 'State/Province', and 'Zip/Postal Code' fields are all filled out. This information is critical for correctly issuing and mailing the payment. An incomplete address will result in a validation failure, preventing submission until all required fields are provided.
6
Validates Federal Tax Withholding Rate
If the user elects to have federal taxes withheld at a specific rate in Section 5, this check ensures the provided value is a number between 0 and 100. This prevents invalid or ambiguous tax instructions. An entry outside this range or a non-numeric value will cause an error, requiring the user to enter a valid percentage.
7
Enforces Mutually Exclusive State Tax Withholding Input
In Section 5, if the user chooses to specify a state tax withholding amount, this validation confirms that they have entered either a percentage OR a dollar amount, but not both. Providing both creates ambiguity for processing. If both fields are filled, the user will be prompted to clear one of the two fields before proceeding.
8
Mandates Owner and Joint Owner Signatures
This check verifies that all required signatures are present in Section 6. The primary contract owner's signature is always mandatory. If a 'Joint Contract Owner Name' is listed in Section 1, their signature is also required. Missing signatures will prevent the form from being processed, as they provide legal authorization for the transaction.
9
Triggers Medallion Signature Guarantee Requirement
This is a logical check that flags the form as needing a Medallion Signature Guarantee based on the rules in Section 6. The system will check if the withdrawal is over $100,000, sent to an alternate payee, or over $30,000 with a recent address change. If any condition is met, the system will inform the user that a Medallion Signature Guarantee is required for the form to be processed, which cannot be completed via a standard electronic submission.
10
Validates Partial Fund Withdrawal Specificity
If the user opts to withdraw from specific annuity funds in Section 2, this check ensures that for each fund listed, exactly one withdrawal instruction ('ALL units', 'percentage', or 'dollar amount') is selected. This prevents conflicting instructions for a single fund. If a user selects more than one option for a fund, an error will be displayed, requiring them to make a single choice per fund.
11
Ensures State of Residence is Provided for Tax Calculation
This validation confirms that the 'State of Residence' field in Section 5 is completed. This information is essential for determining the correct state tax withholding rules and rates, as tax laws vary by state. Failure to provide the state of residence will block form submission, as tax obligations cannot be accurately calculated.
12
Validates Primary Phone Number Format
This check ensures the 'Primary Phone' number in Section 1 is present and follows a standard format (e.g., 10 digits). A valid phone number is crucial in case Fidelity needs to contact the owner with questions about the withdrawal request to avoid delays. An invalid or missing phone number will trigger an error message.
13
Confirms Surrender Attestation Selection
If the user selects to 'Withdraw ENTIRE contract amount (surrender)' in Section 3, this validation ensures they have also selected one of the corresponding options regarding the physical contract document ('lost or destroyed' or 'attached'). This attestation is a required part of the surrender process. The form cannot be submitted for surrender without this selection being made.
14
Verifies Fidelity Account Number for Direct Deposit
If the user chooses 'Directly deposited to a Fidelity nonretirement account' in Section 4, this check validates that the 'Fidelity Nonretirement Account Number' field is filled and matches a valid account number format. This ensures the funds are transferred to the correct destination account. An invalid or missing account number will result in an error, preventing the submission until a valid number is entered.
Common Mistakes in Completing 1.812957.122
Users often overlook the requirement for a Medallion Signature Guarantee, which is needed for withdrawals over $100,000, payments to alternate payees, or large withdrawals after a recent address change. This is different from a notary seal and must be obtained from a financial institution. Failure to provide a required guarantee will result in the immediate rejection of the form, causing significant delays in accessing funds.
The form explicitly requires an original 'ink' signature from all contract owners, but people often submit a photocopy or digital version, which is not accepted. Furthermore, if the contract is jointly owned, the signature of the joint owner is frequently missed. Either error will invalidate the request, requiring the user to print, re-sign, and resubmit the entire form, delaying the withdrawal process.
A common error is filling out both Section 2 (Partial Withdrawal) and Section 3 (Surrender Your Contract). The form is designed for one or the other, not both. This ambiguity forces the processing agent to either guess the user's intent or, more likely, reject the form and contact the user for clarification, delaying the transaction.
In Section 5, users frequently make errors such as entering a dollar amount for federal withholding (which only accepts a percentage) or checking both 'Do NOT withhold' and providing a withholding rate. These conflicting or improperly formatted instructions can lead to incorrect tax withholding or processing delays. To avoid this, carefully select only one option per column and ensure the data type (percentage or dollar amount) matches the field's requirement.
A simple typo or using an outdated number in the 'Annuity Contract Number' field is a frequent mistake. This happens when people guess the number or reference an old document. An incorrect contract number will cause the entire request to fail validation, as Fidelity cannot locate the specified account, leading to an automatic rejection and processing delays.
In Section 2, users may request a specific dollar amount that is below the stated $500 minimum, which will be rejected. Alternatively, when selecting 'Maximum amount available,' they may not realize a minimum balance ($2,500 or $5,000) must remain in the contract. This misunderstanding can lead to confusion when the received amount is less than expected or the request is delayed for clarification.
People often select the Electronic Funds Transfer (EFT) option in Section 4 and provide their bank details, assuming they are adding them. However, the form clearly states this option is only for EFT instructions 'ALREADY IN PLACE' on the contract. This mistake will cause the withdrawal method to fail, and Fidelity will likely default to mailing a check to the address of record, which may be slower and less convenient.
When choosing to withdraw from specific funds in Section 2, users sometimes enter the fund name but forget to specify the exact dollar amount or percentage to be withdrawn. Another common error is checking more than one box (e.g., 'ALL units' and a specific dollar amount) for the same fund. This ambiguity makes it impossible to process the request, which will be returned for correction.
When surrendering the entire contract in Section 3, it is mandatory to check one of the two boxes: 'Original contract has been lost or destroyed' or 'Original contract attached'. People often overlook this simple checkbox. Leaving this blank creates an incomplete request, which will halt processing until the user provides the missing information.
The form is often filled out by hand with illegible handwriting or using a pen color other than black ink, contrary to the instructions. Additionally, users sometimes fail to send all pages of the form. Since this is a flat, non-fillable PDF, these manual errors are common and can lead to data entry mistakes by the processor or rejection. AI-powered tools like Instafill.ai can convert such PDFs into fillable forms, ensuring information is typed, legible, and complete before printing.
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