Equity Redemption Paperwork Request- Age 70 or 78 Equity Redemption Paperwork Request- Age 70 or 78 Age payouts are processed once per year. They are voted on after the fiscal year-end audit by the board of directors. There are no exceptions. For any additional questions, please contact EquityInfo@ALCIVIA.com or call 608.819.3102. Name * Name First First Last Last Account Number(s) Please separate multiple accounts with a comma Is this a joint account? * Yes No Please note that only HALF the equity on a joint account can be requested. The other half belongs to the other person listed on the account. Name of the second person on the account Name of the second person on the account First First Last Last Date of Birth * Customer Age * Customers cannot request age redemption paperwork until they have reached the required age. Customer would like paperwork via: * Email Physical Mail Email Address * Phone Number * Mailing Address * Mailing Address Mailing Address Mailing Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Upload image of valid driver’s license Drop a file here or click to upload Choose File Maximum file size: 157.29MB Please add any additional comments or notes about this request If you are human, leave this field blank. Submit Start Over
