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Questions? | Policy Manual | Training Information

• Information about the annuity owner(s), the spouse of the annuity owner and the annuity issuer in the first box at the top of the first page.
• Information in the “County Address” box found at the bottom of the first page.
• The name and address of the annuity owner(s) on the second page.

Complete a DAIL/WRIT in MAXIS for the day the form should be returned to remind the worker that it is due.

• Complete any ownership information that the worker was not able to complete.
• Have the owner(s) of the annuity, whether it is self, the spouse and/or another owner, sign:
  • The front of the form authorizing the designation of DHS as the PRB, and,
  • The back of the form, authorizing the release of information.
• Also sign Step 4 of the form so that DHS can release applicant information to the issuer.
• Return the completed and signed form by the due date indicated on the DHS-3271.