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Instructions cover eligibility requirements, required Medallion signature guarantee conditions, and key contract and owner details. The form also specifies how to delete or apply EFT instructions, provides bank account and routing details requirements, and includes authorization, certification, and signature/date sections for all contract owners.",{"@graph":63,"@context":123},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/electronic-funds-transfer-eft-annuities/288805/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/electronic-funds-transfer-eft-annuities/288805.png","ImageObject",442,249,{"name":88,"@type":89},"Dozel","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-07","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",8,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115,119],{"name":106,"@type":107,"acceptedAnswer":108},"What is the purpose of the Electronic Funds Transfer (EFT)–Annuities form?","Question",{"text":109,"@type":110},"It is used to set up or modify transfers between an annuity contract and a bank account, and to update EFT instructions for existing Systematic Withdrawal, Income Payments, or Annuity Builder programs.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"Who must be eligible to use EFT?",{"text":114,"@type":110},"Your account must be with an institution that is a member of the Automated Clearing House (ACH) and is a commercial bank, savings and loan, or credit union.",{"name":116,"@type":107,"acceptedAnswer":117},"When is a Medallion signature guarantee required?",{"text":118,"@type":110},"A Medallion signature guarantee is required unless you are establishing EFT for a bank account in your name and attach the appropriate documentation (voided check or account statement for checking; deposit slip or account statement for savings).",{"name":120,"@type":107,"acceptedAnswer":121},"What authorization and certification do contract owners provide on the form?",{"text":122,"@type":110},"By signing, owners authorize Fidelity to act on instructions, accept the form’s terms, certify provided information is correct, and authorize payment processing and related data sharing for fraud prevention verification.","https://schema.org",{"og:url":78,"og:type":125,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":127,"canonical":78},"index,follow",{"doc_id":129,"site_id":56},288805,1790251191,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":88,"user_avatar":134,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":140,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":61,"update_tm":144,"read_time":9},962085662650,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","| Print | Reset | Save |\n| --- | --- | --- |\n\nQuestions? Go to [Fidelity.com/movemoney or](Fidelity.com/movemoney or) call 800-634-9361.  \nElectronic Funds Transfer (EFT)–Annuities  \nUse this form to set up or modify a way to transfer funds between your annuity contract and your bank account, and also to update EFT instructions for an existing Systematic Withdrawal, Income Payments, or Annuity Builder Program. Do NOT use for non-annuity accounts such as Fidelity IRA or Retirement Plans (Keogh). Type on screen or print out and fill in. For best results, use CAPITAL letters and black ink. If you need more room for information or signatures, use a copy of the relevant page.  \nHelpful to Know  \n• To be eligible for EFT, your account must be with an institution that is a member of the Automated Clearing House (ACH) and is a commercial bank, savings and loan, or credit union. Call the institution to determine its membership status.  \n• A Medallion signature guarantee is required unless you are establishing EFT for a bank account in your name and you attach a voided check or account statement (for checking accounts) or a deposit slip or account statement (for savings accounts) .  \n• The table below provides important details about EFT.  \n1. Contract Number/Owner(s)  \nYour annuity contract number can be found  \non a recent statement or the portfolio positions page on Fidelity. com.  \nTrust and UGMA/UTMA Accounts: Provide names of authorized individuals in the Contract Owner fields.  \nPhone numbers will be used if we have questions.  \n| Annuity Contract Number |  |  | Annuity Contract Number |  |  | Annuity Contract Number |  |\n| --- | --- | --- | --- | --- | --- | --- | --- |\n|  |  |  |  |  |  |  |  |\n| Contract Owner Name |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |\n| Joint Contract Owner Name if applicable |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |\n| Evening Phone |  |  |  | Daytime Phone |  |  | Extension |\n|  |  |  |  |  |  |  |  |\n\n2. Existing EFT Information  \nTo delete existing instructions, check the box below or call Fidelity. If you only want to add new instructions, not delete existing instructions, skip to Section 3.  \n Delete existing EFT instructions for the Contract listed in Section 1.  \n3. Apply EFT to Contract Payments/Program(s)  \nSelect ONLY if already established on your contract.  \nIncome payments from your annuity  Systematic Withdrawal Program  Annuity Builder Program  \nForm continues on next page.   \n1.941150.109  \nPage 1  \nof 3  \n028580701  \n4. New EFT Information  \nYour annuity contract and non-annuity contract must have at least one owner’s name in common. We require original, physical checks. No copies are allowed.  \nBank Account  \nCheck ONLY one.  Checking  Attach voided check with your full name preprinted on it or account statement. Do NOT attach deposit slip.  \n Savings  Attach deposit slip or account statement and provide bank routing number.  \nAsk your bank for the correct routing number.  \n| Owner(s) Name(s) Exactly as on Bank Account |  |\n| --- | --- |\n|  |  |\n| Bank Routing /ABA Number (Nine digits, starts with 0, 1, 2, 3, or 4) | Bank Name |\n|  |  |\n| Checking or Savings Account Number |  |\n|  |  |\n\nIf you do not attach a   \nvoided check, a savings deposit slip, or a bank statement, you MUST obtain a Medallion signature guarantee in Section 5.  \nFor  \nı :101205681 ı :1001 ıı ∙7799501999999  \nAttach here:  \nExample of ABA routing number  \nExample of account number  \nFidelity Nonretirement Account  \nNote that distributions to a brokerage account will be deposited to the core position only.  \n\n| Fidelity Nonretirement Account Number | Fidelity Fund Name or Symbol Mutual fund accounts ONLY. |\n| --- | --- |\n|  |  |\n\n5. Signature and Date Form cannot be processed without signature and date of ALL contract owners.  \nBy signing below, you:  \n• Authorize Fidelity to act on all instructions given on this form.  \n• Accept all terms and conditions described in this form.  \n• Certify that all inform","cbCaikMtln7BhJLn","https://ap.wps.com/l/cbCaikMtln7BhJLn","pdf",1122599,"English","# Helpful to Know\n## Eligibility and signature guarantee requirements\n# Contract Number/Owner(s)\n## Owner and phone details\n# Existing EFT Information\n## Deleting or adding EFT instructions\n# Apply EFT to Contract Payments/Program(s)\n## Income payments and program selection\n# New EFT Information\n## Bank account and non-annuity account linking\n# Signature and Date\n## Authorization terms and who must sign","[{\"question\":\"What is the purpose of the Electronic Funds Transfer (EFT)–Annuities form?\",\"answer\":\"It is used to set up or modify transfers between an annuity contract and a bank account, and to update EFT instructions for existing Systematic Withdrawal, Income Payments, or Annuity Builder programs.\"},{\"question\":\"Who must be eligible to use EFT?\",\"answer\":\"Your account must be with an institution that is a member of the Automated Clearing House (ACH) and is a commercial bank, savings and loan, or credit union.\"},{\"question\":\"When is a Medallion signature guarantee required?\",\"answer\":\"A Medallion signature guarantee is required unless you are establishing EFT for a bank account in your name and attach the appropriate documentation (voided check or account statement for checking; deposit slip or account statement for savings).\"},{\"question\":\"What authorization and certification do contract owners provide on the form?\",\"answer\":\"By signing, owners authorize Fidelity to act on instructions, accept the form’s terms, certify provided information is correct, and authorize payment processing and related data sharing for fraud prevention verification.\"}]","Electronic Funds Transfer (EFT) - Annuities | PDF",1789633947]