Forms Revisions to Add DOL Disclosure – Effective Monday, 06/13/22

Effective Monday, June 13, 2022, the following forms will be updated to support the addition of Department of Labor disclosure language: the Customer Information Form (ORD 115582 2022) and Notice Regarding Modified Endowment Contracts (ORD 86958-2022).

Revised Customer Information Form

The Customer Information Form (ORD 115582 2022) has been updated as follows:

• The DOL disclosure has been added above the Instructions on page 1.
• The form will carry a revision date of 2022. 

Revised Notice Regarding Modified Endowment Contracts 

Notice Regarding Modified Endowment Contracts (ORD 86958-2022) has been updated as follows:

• The DOL disclosure has been added above the Instructions on page 1.
• The form will carry a revision date of 2022.

The revised Customer Information Form and Notice Regarding Modified Endowment Contracts forms are required with applications with a Part 1 date of June 13, 2022, and later. 

The revised forms will be available on the PruXpress website and iGo effective June 13, 2022.