Simply fill out the required information electronically, then print, sign and return it to the address on the form.
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Submit address or name changes for yourself or other parties on your contract, or to add, change or delete a third party listed on your policy to receive billing notices
Request conversion of a deferred annuity to irrevocable payments
Required to show signing authority for contracts owned by a Trust for Genworth Life and Annuity Insurance Company (GLAIC) and Genworth Life Insurance Company (GLIC)
Required to show signing authority for contracts owned by a Trust for Genworth Life Insurance Company of New York (GLICNY)
Required to show signing authority for an Attorney-in-Fact acting under a Power of Attorney for the contract owner
Request a duplicate copy of a lost or destroyed policy or contract
Request annuity payments to be deposited directly into your bank account or to update bank account information for policies or contracts currently having payments deposited via electronic funds transfer
Request automatic withdrawals from your bank account to pay premiums on life or long term care insurance policies, or to update bank account information for policies already drafting premiums
Authorize us to share your information with a third party you designate
Request owner and beneficiary changes on Immediate Annuities issued between 2/14/2000 and 11/13/2005
Request owner, payee or beneficiary changes on any life insurance policy or annuity contract (except Immediate Annuities issued between 2/14/2000 and 11/13/2005)
Policy conversion or decrease authorization (Coming Soon... )
Request conversion of a life insurance policy, decrease coverage or reduce benefits where no evidence of insurability is required
Restrict the payout option for any beneficiary of a variable annuity
Request a loan or withdrawal on your life insurance policy or to request a full surrender of your policy
Request systematic withdrawals from a variable annuity contract
Request a single withdrawal from a fixed annuity or authorize future transactions to be requested over the telephone by you or an authorized family member.
Request a single withdrawal from a variable annuity or authorize future transactions to be requested over the telephone by you or an authorized family member.
Request a systematic or auto interest withdrawal from a fixed annuity.
Request a Required Minimum Distribution from a fixed annuity.
Request a Required Minimum Distribution from a variable annuity.
