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Electronic funds transfer (EFT) authorization - Genworth

Only Genworth Life Insurance Company of New York is admitted in and conducts business in New Life & Annuity Genworth LifeGenworth Life of New YorkP. O. Box 40016 Lynchburg, Virginia 24506-4016 Tel: 888 Genworth ( )Fax: 877 funds transfer (EFT) authorization for renewal premiumsfrom Genworth Life and Annuity Insurance Company, Genworth Life Insurance Company and Genworth Life Insurance Company of New York Page 1 of 1 EFTAuthS-PHS 02/29/16 Policy numberb Insured name(s) Date of birth b b Policy informationPremium paymentsUse this section to select your payment frequency for your scheduled premium withdrawals.

Electronic funds transfer (EFT) authorization for renewal premiums from Genworth Life and Annuity Insurance Company, ... By signing this form, I (the bank account owner) understand and accept these terms and conditions: • You will withdraw the scheduled premium payments from my account

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Information about your IRS Form 1099-LTC

www.genworth.com

of long-term care benefits issued under your insurance contract, on a yearly basis. Since your contract is not tax qualified, some or all of your benefits may be taxable. You will need to determine the taxable portion of non-qualified long-term care benefits for purposes of your individual income tax return.

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Surrender Instructions and Guidelines - Genworth

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do not have much, if any, value available for surrender, they may offer the possibility of continuing a substantial death benefit for little or no additional premium payments, which may be more advantageous to you than surrendering your policy now for little or no value.

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