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Get AA1085 2005-2024

Es). Any insurer checked above is herein referred to as the Company. Berkshire Life Insurance Company of America is a wholly owned stock subsidiary of and an administrator for The Guardian Life Insurance Company of America, New York, NY For value received, I (the Assignor/Owner ), do hereby assign all my right to receive any indemnity which may become due or payable under the Company Policy No. (the Policy ) to ( Assignee ) whose address is ; Street City State Zip reserv.

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