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The document is a Variable Annuity Surrender Request form, intended for individuals seeking to fully or partially surrender their variable annuity. It outlines the procedures, requirements, and restrictions for submitting the request, including specific instructions for different types of surrenders and tax implications. The form also provides contact information and important notes regarding potential impacts on benefits and charges associated with the surrender.

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Click 'Get Form' to open the Variable Annuity Surrender Request in the editor.
Begin by completing Section A, which requires your contract owner information. Fill in your contract number, name, Social Security or Tax Identification Number, and contact details.
In Section B, indicate whether you want to surrender all or part of your annuity funds. Choose the appropriate option and proceed to the relevant section.
For partial surrenders, complete Section D by specifying the amount you wish to withdraw. Ensure you select one of the provided options for determining your check amount.
If applicable, modify your Automatic Income Program payments in Section E based on how you want future payments handled after your surrender.
Review Sections F through J carefully. Ensure all required fields are filled out accurately and sign where indicated to finalize your request.

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