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Get VALIC VL 20798 2009

________________________________ Daytime Phone: (______) ____________ SSN or Tax ID: _____________________________________ Date of Birth: _____________________________ Group #: ___________________________ Plan Name: __________________________________________________________________ Plan #: _____________________________ 2. RoLLoVeR/tRAnSfeR oUt ReQUeSt Indicate if you are requesting a Rollover or a transfer by checking one of the boxes below. See Information pages for more details.  Roll.

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