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Get American General Life Insurance Withdrawal Request Form Agl 162 12 19

# Date Annuitant/Participant Owner Owner s Address Daytime Telephone # Note: If you borrow, surrender, or withdraw any funds from your policy/contract/certificate, the guaranteed elements, non-guaranteed elements, face amount, or surrender value of your existing policy/contract/certificate may be affected. I/We request a withdrawal under the provisions of the subject policy/contract/certificate. Benefits applicable to the amount withdrawn are waived. I/We understand the policy/contract.

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