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Get Massmutual Surrender Form

Owner/Participant Information Contract/Certificate Number Questions: (800) 272-2216 Fax (toll free): (866) 329-4272 Email: ANNfax massmutual.com We will only accept responsibility for forms submitted as indicated above. above. Daytime Telephone Number Owner/Participant Name (Please Print) Social Security Number Joint Owner/Participant Name (If Applicable) Social Security Number Address (Street) Date Address (City State, Zip) II. Custom Plan Feature Options Complete this section.

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