Common Contracts
2 similar Assignment and Transfer Request contracts by Agl Separate Account D, U S Life Insurance Co in City of Ny Sep Act Usl Va-R
AMERICAN GENERAL LIFE INSURANCE COMPANY ASSIGNMENT AND TRANSFER REQUEST _______ _______________________________________________________________________________ ______________________________________________ Current Trustee/Custodian: | Telephone...Assignment and Transfer Request • April 26th, 2001 • Agl Separate Account D
. Section 1035 of the Internal Revenue Code permits certain nontaxable exchange of insurance policies and annuity contracts. It is my intention that this transfer qualify as a Section 1035 exchange and that no portion of this exchange be actually or constructively received by me. American General Life Insurance Company make no representation concerning my tax treatment for this transaction and has neither responsibility not liability for my tax treatment. . I understand the exact amount of the proceeds may vary depending upon the date of transfer and I agree to execute any additional documents required to complete the transfer. . I understand that the exchange is not complete if the company issuing the contract is unable or unwilling to pay the value of the above referenced contract(s) to American General Life Insurance Company. . I understand that as of the date of surrender of the contract by the company, the surrendered contract no longer provides any coverage and the new contract i
Type of Transfer: (Choose only one) [ ] Non-Qualified Transfer [ ] Qualified Rollover [ ] Qualified Direct Transfer [ ] 1035 Non-Taxable Exchange (Transfer of funds from a (Irrevocable Direct (Direct Transfer from [ ] Other:__________________________...Assignment and Transfer Request • May 26th, 1999 • U S Life Insurance Co in City of Ny Sep Act Usl Va-R
