Impersonation Mode

The forms listed below can be used for a variety of account-related activities including, redemption, beneficiary changes and maintenance.

Please review each form carefully. Some of the resulting transactions may generate a financial or tax impact on your account. Please consult with your registered representative or tax advisor for assistance in determining the appropriateness of a proposed transaction.

The fillable form icon indicates that the form can be opened, filled-in, and then printed. Fillable forms cannot be saved or emailed with filled in data.

Avoid highlighting forms submitted to Pacific Life. Forms are scanned into an imaging system at Pacific Life and highlighting can obscure written entries and instructions.

If you have questions about how to complete these forms, please contact our service representatives at .

Select the desired form from the list below.

General Forms
Retail Accounts
Individual Retirement Accounts
Coverdell Education Saving Account (COVERDELL ESA)
Other Forms

403(b)(7)

403(b)(7) Account Distribution Request
[Contact Customer Service toll free at (800) 722-2333, Option 2, to request a copy of the 403(b) Distribution Request form.]