Asset Transfer Request Form Page 3
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3dO nOT complete this page if you want this asset transfer to be deposited the same
as the investment option already on file.
7. Lincoln contract information
Complete this section for Multi-Fund
contracts only.
®
Investment funds selection must be in whole percentages and total 100%.
Preservation of Capital
Long Term Growth
% Fixed Account (FIXED ACCT)
% American Funds Global Growth (AMF GL GR)
% LVIP Money Market (LN MNY MKT)
% American Funds Growth (AMF GROW)
Income
% American Funds International (AMF INT’L)
% Delaware VIP
Diversified Income (DLW DVRSIN)
% Delaware VIP
Small Cap Value (DLW SMCP V)
®
®
% Delaware VIP
High Yield (DLW HI YLD)
% Fidelity
VIP Contrafund
(FID CONTRA)
®
®
®
% LVIP BlackRock Inflation Protected Bond (BKRK INFPT)
% Fidelity
VIP Growth (FID VIP GR)
®
% LVIP Delaware Bond (LN BOND)
% LVIP Clarion Global Real Estate (LN GL REIT)
% LVIP Delaware Diversified Floating Rate (LN DVRS FR)
% LVIP Delaware Social Awareness (LN SC AWRN)
% LVIP Global Income (GLOBAL INC)
% LVIP Delaware Special Opportunities (LN SPC OPP)
% LVIP SSgA Bond Index (BOND IDX)
% LVIP Dimensional U.S. Core Equity 1 (DM CORE 1)
% PIMCO VIT Total Return (PIMCO VIT)
% LVIP JPMorgan Mid Cap Value Managed Volatility (JPM MD VAL)
Growth & Income
% LVIP Mondrian International Value (LN INT’L)
% American Funds Growth-Income (AMF GR&IN)
% LVIP SSgA International Index (INT’L IDX)
% BlackRock Global Allocation V.I. (BK RK GL A)
% LVIP SSgA S&P 500 Index (S&P 500 IN)
% Delaware VIP
REIT (DLW REIT)
% LVIP Templeton Growth Managed Volatility (TEMP GR)
®
% Delaware VIP
Value (DLW VALUE)
% LVIP UBS Large Cap Growth Managed Volatility (UBS LCP GR)
®
% LVIP BlackRock Equity Dividend Managed Volatility (BKRK EQDIV)
% LVIP Vanguard Domestic Equity ETF (LN VNG DE)
% LVIP Delaware Foundation
% LVIP Vanguard International Equity ETF (LN VNG INT)
Aggressive Allocation (DLW FND AG)
®
% LVIP Delaware Foundation
% MFS
VIT Utilities (MFS UTILTS)
®
Conservative Allocation (DLW FND CN)
®
% LVIP Delaware Foundation
Maximum Capital Appreciation
Moderate Allocation (DLW FND MD)
®
% LVIP Global Conservative Allocation Managed Risk (LN GLB CON)
% AB VPS Global Thematic Growth (AB VPS GL T)
% LVIP Global Growth Allocation Managed Risk (LN GLB GR)
% Delaware VIP
Smid Cap Growth (DLW SMID)
®
% LVIP Global Moderate Allocation Managed Risk (LN GLB MOD)
% Deutsche Alternative Asset Allocation VIP (DEU ALT AL)
% LVIP Managed Risk Profile 2010 (LN 2010 PF)
% LVIP Baron Growth Opportunities (BRN GR OPP)
% LVIP Managed Risk Profile 2020 (LN 2020 PF)
% LVIP BlackRock Emerging Markets Managed Volatility (BL RK EMRG)
% LVIP Managed Risk Profile 2030 (LN 2030 PF)
% LVIP Ivy Mid Cap Growth Managed Volatility (IVY MID GR)
% LVIP Managed Risk Profile 2040 (LN 2040 PF)
% LVIP SSgA Emerging Markets 100 (EMERG MKTS)
% LVIP Managed Risk Profile 2050 (LN 2050 PF)
% LVIP SSgA Small-Cap Index (SM CAP IN)
% LVIP SSgA Global Tactical Allocation Managed Volatility (SS GLB TAC)
% LVIP T. Rowe Price Structured Mid-Cap Growth (TRP MIDCAP)
Participant’s signature ________________________________________________________________ ___ Date ________/_______/_____________
Entire form must be sent to:
Mail to:
Servicing Office
By Express Mail:
The Lincoln National Life Insurance Company
The Lincoln National Life Insurance Company
1300 South Clinton Street
PO Box 2340
Fort Wayne, IN 46802-3506
Fort Wayne, IN 46801-2340
Telephone number: 800-454-6265
Fax number: 260-455-1874
variable annuity is issued on contract form numbers 18829, 18831, 25982, 28645, 30070-B and state variations and Lincoln Life Group Fixed Annuity on contract form numbers 19346,
Multi-Fund
®
26378 and state variations by The Lincoln National Life Insurance Company, Fort Wayne, IN, and distributed by Lincoln Financial Distributors, Inc., Radnor, PA, a broker-dealer. Contractual
obligations are subject to the claims-paying ability of The Lincoln National Life Insurance Company.
Product and features subject to state availability. Limitations and exclusions may apply.
Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Affiliates are separately responsible for their own financial and contractual obligations.
PAD-1174423-041515
Page 3 of 3
RPS22135-MF9
05/15
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