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Ay be withdrawn is $100.00 for Provider; $500.00 for Legacy Creator SPVUL. I REQUEST A WITHDRAWAL AMOUNT OF: $ Please check 1 or 2: 1. (Gross) I understand that I may receive less than this amount if I elect to have taxes withheld and/or a surrender charge applies. 2. (Net) I wish to receive the full amount specified above. I understand that the amount deducted from my policy may be greater if I elect to have taxes withheld and/or a surrender charge applies. If this partial withdrawal includes.

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