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Get Valic Vl 8725 2013

15648, Amarillo, TX 79105-5648 Call 1-800-448-2542 for assistance. 1. Client Information Name:______________________________________________________________ SSN or Tax ID: ___________________________________________ Daytime Phone: (_______)____________________________ Date of Birth: ___________________________ 2. DISTRIBUTION REQUEST Please select either OPTION A or OPTION B below. Selecting both options will delay processing your distribution request. In accounts/contracts containing.

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