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Ownership and beneficiary designation request for life insurance policies from Genworth Life and Annuity Insurance Company Genworth Life Genworth Life and Annuity Genworth Life of New York P. Please print clearly using blue or black ink and cross through initial and date any corrections or we may not be able to accept your request. Only Genworth Life Insurance Company of New York is licensed in New York. Policy number s Use only the spaces needed.

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