Transcription of Life Surrender Request - 11090
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Life Surrender Request - 11090
11090R6-20 Page 1 of 5 Life Surrender Request 1. Insured InformationMember IDContract numberEmailName2. Surrender Type a. Value Distribution Full Surrender (this will close the contract and terminate coverage) Partial Surrender (Universal Life/Variable Universal Life only)$ Loan$b. Loan c. Dividend Surrender /Change (Traditional Life only) Dividend/Surplus Refund Release$ Dividend/Surplus Refund Option Change3. Delivery of Payment Check Direct Deposit Complete bank information for direct depositFull name of bank account owner(s)Full name of bankChecking SavingsAccount typeRouting numberAccount number Apply to another Thrivent contract/account. Contract number Loan repayment Premium amount $$$$ Add to amount requested.
Surrender/decease charges may apply. Any distribution request or dividend/surplus refund option change processed will invalidate any previous sales illustrations. Contact your representative for an illustration that shows the effects of …
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