SIGNING AUTHORITY, FIDUCIARY CAPACITY FORMS
Annuity, Life and Long Term Care Products

Simply fill out the required information electronically, then print, sign and return it at the address on the form.

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Certification of trustee powers - GLAIC/GLIC

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)

Certification of trustee powers - GLICNY

Required to show signing authority for contracts owned by a Trust for Genworth Life Insurance Company of New York (GLICNY)

Declaration of attorney-in-fact

Required to show signing authority for an Attorney-in-Fact acting under a Power of Attorney for the contract owner