â–« Title of the action. Use this form to authorize the company to start paying benefits included in a Guaranteed Lifetime Withdrawal Rider and submit it to the Nassau Service Center.Use Form RP524, Complaint on Real Property Assessment to grieve your assessment. Applications MUST be made using the Request for Adjournment Form attached hereto. If the OWNER is a NON-INDIVIDUAL, complete the following. Full Name of Trust, Entity, Corporation or Other: Date of Trust. This agreement will not be in effect until your first payment has been received and processed.