Change my 403b to an IRA

1.  On the top of the form mark Life Insurance Company of the Southwest

2. Complete contact information.

3. Do not complete anything else on the first page.

1. Complete CHANGE TAX QUALIFICATIONS TYPE

2.  FROM: 403B

3.  TO: TRADITIONAL IRA

4. Skip down to the section highlighed in purple...date & sign

You can email forms & copy of your proof back to me: phronsie@askphronsie.com

Or you can fax directly to National Life Group: 214-638-9162