GENWORTH FINANCIAL FORMS
403(b) New Issue Form - 13245
Additional Premium Receipt - 16430
Agent of Record Change Request - 14271 [Generic]
Annuitization Request For Fixed Annuities - 43851ANR [Generic]
Annuity Claim Form - GLAIC - 19895
Annuity Contract Change Form - 48972
Annuity Suitability Profile - 49655
Annuity Transfer and Exchange - 42923 [Generic]
Annuity Wire Transfer Instructions - GLIC-GLAIC - 41310
Annuity Wire Transfer Instructions - GLICNY - 41310NY [NY]
Automatic Portfolio Rebalancing Form - 19645
Automatic Premium Payment - Checking or Savings - GC02036
Bank Draft Authorization - 03018
Bank Draft Authorization - 03018NY [NY]
Bank Draft Authorization - 14221NY [NY]
Certification of Trustee Powers - GNWCertTrst-NY [NY]
Collateral Assignment of Policy - 2602
Designation of Multiple Owners - Existing Policies - 13607
Disclosure for Annuitants 85 or Older - 36117
Disclosure for Annuitants 85 or Older - 36117NY [NY]
Disclosure Notice - 37595 [MN]
Duplicate Contract Request - 43802
Electronic Funds Transfer Authorization - EFTauthAnn
Employer 403(b) Information Sharing Agreement - 43874
Enhanced Dollar Cost Averaging Program for Sales - 15628
Federal & State Tax Withholding for Annuity Payments - 38249
Fixed Annuity Contract Maintenance Form - 14547NY [NY]
Fixed Annuity Disclosure (ACLI Standard) - Advantage - 44548 [IA]
Fixed Annuity Disclosure (ACLI Standard) - America Plus - 44548AP [IA]
Fixed Annuity Disclosure (ACLI Standard) - Cornerstone 5 - 44548C5 [IA]
Fixed Annuity Disclosure (ACLI Standard) - Independence - 44548I [IA]
Fixed Annuity Disclosure (ACLI Standard) - Smart Rate - 44548SR [IA]
Fixed Annuity Disclosure (ACLI Standard) - Stable 5 - 44548S5 [IA]
Fixed Annuity Disclosure Notice - 35424 [NY]
Fixed Annuity Disclosure Notice to PA Applicants - 35199PA [PA]
Fixed Annuity Partial Withdrawal - Automatic Interest and Full Surrender Form - 38329NY [NY]
Fixed Annuity Point of Sale Disclosure - Automated Order Entry - 41057 [VA]
Fixed Annuity Point of Sale Disclosure - Automated Order Entry - 41057PA [PA]
Fixed Annuity Required Minimum Distribution - NS31181NY [NY]
Fixed Annuity Suitability Questionnaire - 48743FA
Fixed Annuity Systematic Withdrawal Request - 38330NY [NY]
Foundation Optional Rider Reset Form - Chase - 36255 [NY]
Foundation Optional Rider Reset Form - Chase - 36255CB
Foundation Variable Annuity App Supp - Instructions - Chase - 15351ANCB [Multi-State]
Foundation Variable Annuity App Supplement - Instructions - Chase - 15351ANCBNY [NY]
Guaranteed Income Rider Segment Form - 35111
Illustration of Minimum Guaranteed Interest Rate - 39098CTA [CT]
Illustration of Minimum Guaranteed Interest Rate - 39099CTSR [CT]
Immediate Annuity New Business NIGO Checklist - 48382SPIA
Immediate Annuity to LTC Funding Request - 49787
Immediate Annuity to LTC Funding Request - Existing Immediate Annuities - 49787PI
Investment Strategy Allocation Worksheet - 35323
Investment Strategy Allocation Worksheet - Chase - 35323CB
Investment Strategy Allocation Worksheet - Chase - 35323CBNY [NY]
IRA Annuity Broker Guide - 45080ML
IRA Annuity Broker Guide - LIPS - 45080S
IRA Annuity Broker Guide with Commission - 45080
IRA Annuity Broker Guide with Commission - 45080IBDNYS
IRA Annuity Broker Guide with Commission - 45080IBDS
Medical Care-Nursing Home Fee Waiver - Fixed Annuities - 35393
NAIC Fixed Annuity Buyers Guide - 35274 [Multi-State]
NAIC Fixed Annuity Buyers Guide - 35274I [WI]
NAIC Fixed Annuity Buyers Guide - 35274NH [NH]
Notice Regarding Income Taxes - GEFA-TAX-N
Notice Regarding Income Taxes - NY-TAX-N [NY]
Personal Income Design Forms Packet - Raymond James - 46364RJ [Generic]
Personal Income Design Forms Packet - Raymond James - 46364RJNY [NY]
Personal Income Design LIP08 App - Raymond James - 35204RJ [Generic]
Personal Income Design LIP08 App - Raymond James - 35204RJ [PA]
Personal Income Design LIPSOL App - 46416 [Generic]
Personal Income Design LIPSOL App - 46416CA [CA]
Personal Income Design One and Personal Income Design One NY Portfolio Expenses - 48796PID [Generic]
Personal Income Design One App - 49762 [Generic]
Personal Income Design One App - 49762AZ [AZ]
Personal Income Design One App - 49762MN [MN]
Personal Income Design One App - 49762NC [NC]
Personal Income Design One App - 49762NY [NY]
Personal Income Design Replacement Forms Packet - Raymond James - 46364RJR [Generic]
Plan Information Form - 13449
Registered Investment Adviser Disclosure for Efficient Edge Asset Allocation Models - 49364 [MN]
Replacement Comparison Statement - 46028 [NV]
Replacement Form - 11950 [VA]
Replacement Form - 11950C [KY]
Replacement Form - GEFA - 1887
Replacement Form - GEFA1800 [Multi-State]
Replacement Form - GEFA1850 [SD]
Replacement Form - GEFA1851 [KS]
Replacement Form - GEFA1874 [CA-ID-NE-OH-SC]
Replacement Form - GEFA1874 [CA]
Replacement Form - GEFA1886 [MN-WI]
Replacement Form - GEFA1889 [GA]
Replacement Form - GEFA1893 [IN]
Replacement Form - GEFA1895 [FL]
Replacement Form - GEFA1900 [OK]
Replacement Form - GEFA1904 [MO]
Replacement Form - GEFA1907 [AR]
Replacement Form - GEFA1908 [MI]
Replacement Form - GEFA1909 [MI]
Replacement Form - GEFA1910 [DE]
Replacement Form - GEFA1913 [IL]
Replacement Form - GEFA1914 [IL]
Replacement Form - GEFA1915 [WY]
Replacement Form - GEFA1917 [NV]
Replacement Form - GEFA1918 [TN]
Replacement Form - GEFA1921 [PA]
Replacement Form - GEFA1928 [MA]
Replacement Form - GEFA1929 [WA]
Replacement Form - GEFA1952 [FL]
Replacement Form - GNW-1800NJ [NJ]
Replacement Form - GNW1800 [Multi-State]
Replacement Form - NS31285 [Generic]
Replacement Form - NY-1887 [NY]
Replacement Form - NY-1888 [NY]
Replacement Form - NY-1889 [NY]
Replacement Form - NY-1890 [NY]
Replacement Form - NY-1891 [NY]
Replacement Form - NY-1892 [NY]
Replacement Forms Packet - 50443FL [FL]
Replacement Memorandum - 50135 [AR]
Replacement Model - NAIC - 41837OH [OH]
Replacement Notice - 11161G [KS]
Replacement Notice - 11161H [KS]
Replacement Notice - 11950A [GA]
Replacement Notice - 11950D [ID]
Replacement Notice - 11950E [MO]
Replacement Notice - 11950F [CA]
Replacement Notice - 11950H [DE]
Replacement Notice - 11950I [IL]
Replacement Notice - 11950K [NV]
Replacement Notice - 11950L [TN]
Replacement Notice - 11950P [WY]
Replacement Notice - 11950Q [MA]
Replacement Notice - 11950R [WA]
Replacement Notice - 11950T [SD]
Replacement Notice - 11950V [MN]
Replacement Notice - 11968B [IN]
Replacement Notice - 11968C [AR]
Replacement Notice - 11968D [OK]
Replacement Notice - 11968F [MI]
Replacement Notice - 11968H [PA]
Replacement Notice - GEFA-1800SC [SC]
Replacement Sales Certification - 16747 [Multi-State]
RetireReady Choice and Selections Optional Rider Reset Form - 36255
RetireReady Choice Application - 48410 [Generic]
RetireReady Choice Application - 48410OR [OR]
RetireReady Choice Application - 48410PA [PA]
RetireReady Choice Application - Smith Barney - 48410SB [Generic]
RetireReady Choice Application - Smith Barney - 48410SBOR [OR]
RetireReady Choice Application - Smith Barney - 48410SBPA [PA]
RetireReady Extra LIPSOL App - 46418AZ [AZ]
RetireReady Extra LIPSOL App - 46418CA [CA]
RetireReady Freedom LIPSOL App - 46417 [Generic]
RetireReady Freedom LIPSOL App - 46417CA [CA]
RetireReady Freedom VA App - 35205 [Generic]
RetireReady Freedom VA App - 35205 [PA]
RetireReady One and RetireReady One NY Portfolio Expenses - 48796 [Generic]
RetireReady One Application - 48126 [Generic]
RetireReady One Application - 48126AZ [AZ]
RetireReady One Application - 48126MN [MN]
RetireReady One Application - 48126NC [NC]
RetireReady One Application - 48126NY [NY]
RetireReady One Application - Smith Barney - 48126SB [Generic]
RetireReady One Application - Smith Barney - 48126SBAZ [AZ]
RetireReady One Application - Smith Barney - 48126SBMN [MN]
RetireReady One Application - Smith Barney - 48126SBNC [NC]
RetireReady One Application - Smith Barney - 48126SBNY [NY]
RetireReady Selections Application - 48472 [Generic]
RetireReady Selections Application - 48472OR [OR]
RetireReady Selections Application - 48472PA [PA]
RIA Acknowledgement - Efficient Edge Asset Allocation - 40278
Sample Statement - LIP 08 [PA]
Secure Access Account Beneficiary Designation-Change - 13913 [Generic]
Secure Living Advantage Application - 35222 [Generic]
Secure Living Advantage Application - 35222B [IN-MI]
Secure Living Advantage Application - 35222BIL [IL]
Secure Living Advantage Application - 35222CA [CA]
Secure Living Advantage Application - 35222CT [CT]
Secure Living Advantage Application - 35222IL [IL]
SecureLiving Advantage Acknowledgment - 38918A [Generic]
SecureLiving Advantage Acknowledgment - 38918ANY [NY]
SecureLiving Advantage Fixed Deferred Annuity Application - 35222A [MA-TX]
SecureLiving Advantage NY Application - 35222NY [NY]
SecureLiving Advantage Pro Application - 46254 [Generic]
SecureLiving Advantage Pro Application - 46254A [MA-TX]
SecureLiving Advantage Pro Application - 46254CA [CA]
SecureLiving Advantage Pro Application - 46254CT [CT]
SecureLiving Advantage Pro Application - 46254IL [IL]
SecureLiving Advantage Pro Application - 46254NC [NC]
SecureLiving Advantage Pro Disclosure Notice - 38918PRO [Generic]
SecureLiving Advantage Pro Disclosure Notice - 38918PRONY [NY]
SecureLiving Advantage Pro NY Application - 46254NY [NY]
SecureLiving AdvantageChoice Disclosure Notice - 38918CBAC [Generic]
SecureLiving AdvantageChoice Disclosure Notice - 38918CBACAR [AR]
SecureLiving AdvantageChoice Disclosure Notice - 38918CBACNY [NY]
SecureLiving AmericaPlus Acknowledgement - 38918AP [Generic]
SecureLiving AmericaPlus Acknowledgement - 38918APAR [AR]
SecureLiving AmericaPlus Acknowledgement - 38918APNY [NY]
SecureLiving Cornerstone5 Annuity Disclosure - 38918C5 [Generic]
SecureLiving Cornerstone5 Fixed Deferred Annuity Application - 38061A [MA-TX]
SecureLiving Cornerstone5 Fixed Deferred Annuity Application - 38061NC [NC]
SecureLiving Fixed Annuity Materials Catalog - 42311 [Generic]
SecureLiving Income Provider - GLIC-GEC6012 - Guide to Forms - 36217 [Generic]
SecureLiving Income Provider - Producer Guide - 45916 [Generic]
SecureLiving Income Provider - Producer Guide - 45916CA [CA]
SecureLiving Income Provider - Producer Guide - 45916MA [MA]
SecureLiving Income Provider - Producer Guide - 45916NC [NC]
SecureLiving Income Provider - Producer Guide - 45916NY [NY]
SecureLiving Income Provider - Producer Guide - 45916OR [OR]
SecureLiving Income Provider - Producer Guide - 45916R [Multi-State]
SecureLiving Income Provider - Producer Guide - 45916VA [VA]
SecureLiving Income Provider Application - 48130 [Generic]
SecureLiving Income Provider Application - 48130A [CT-TX]
SecureLiving Income Provider Application - 48130B [NJ-OH-VA]
SecureLiving Income Provider Application - 48130MA [MA]
SecureLiving Income Provider Application - 48130MD [MD]
SecureLiving Income Provider Application - 48130NC [NC]
SecureLiving Income Provider Application - 48130NV [NV]
SecureLiving Income Provider Application - 48130NY [NY]
SecureLiving Income Provider Application - 48130OR [OR]
SecureLiving Income Provider Producer Guide App - GLIC-GEC6012 - Chase - 38579CBNJ [NJ]
SecureLiving Independence Acknowledgment - 38918I [Generic]
SecureLiving Independence Acknowledgment - 38918INY [NY]
SecureLiving Independence App - 38064 [Generic]
SecureLiving Independence App - 38064CA [CA]
SecureLiving Independence App - 38064CT [CT]
SecureLiving Independence App - 38064IL [IL]
SecureLiving Independence App - 38064NC [NC]
SecureLiving Independence Fixed Deferred Annuity Application - 38064A [MA-TX]
SecureLiving Liberty Disclosure Notice - 38918L [Generic]
SecureLiving Liberty Disclosure Notice - 38918LNY [NY]
SecureLiving Liberty NY Application - 46253NY [NY]
SecureLiving Policy Delivery Receipt - 15279 [Generic]
SecureLiving SecureDirect5 Acknowledgment - 38918SD5
SecureLiving SecureDirect5 NY Acknowledgment - 38918SD5NY [NY]
SecureLiving SmartRate Acknowledgment - 38918SR
SecureLiving SmartRate Acknowledgment - Chase - 38918CBSR [Generic]
SecureLiving SmartRate Acknowledgment - Chase - 38918CBSRAR [AR]
SecureLiving SmartRate Acknowledgment - Chase - 38918CBSRNY [NY]
SecureLiving SmartRate App - 35387 [Generic]
SecureLiving SmartRate App - 35387A [MA-TX]
SecureLiving SmartRate App - 35387CA [CA]
SecureLiving SmartRate App - 35387CT [CT]
SecureLiving SmartRate App - 35387IL [IL]
SecureLiving SmartRate App - 35387NY [NY]
SecureLiving SmartRate NY Acknowledgment - 38918SRNY [NY]
SecureLiving Stable5 Application - 39174 [Generic]
SecureLiving Stable5 Application - 39174A [MA-TX]
SecureLiving Stable5 Application - 39174CA [CA]
SecureLiving Stable5 Application - 39174CT [CT]
SecureLiving Stable5 Application - 39174IL [IL]
SecureLiving Stable5 Application - 39174NC [NC]
SecureLiving Stable5 Disclosure Notice - 38918CBS5 [Generic]
SecureLiving Stable5 Disclosure Notice - 38918CBS5AR [AR]
SecureLiving Stable5 Disclosure Notice - 38918CBS5NY [NY]
SecureLiving Stable5 Disclosure Notice and Acknowledgement - 38918S5 [Generic]
SecureLiving Stable5 Disclosure Notice and Acknowledgement - 38918S5NY [NY]
SecureLiving Stable5 NY Application - 37391NY [NY]
SPIA Application - Warehouse Version - 45859 [NJ-UT]
SPIA Application - Warehouse Version - 45859MA [MA]
SPIA Large Case Form - 31390
SPIA Processing Checklist - Merrill Lynch - 36320
Telephone and Electrontic Transfer Authorization - 13656
Trust Designation - Existing Business - 13515
Trust Designation - New Issues - 13514
Trust Ownership of Annuity Contract - 15178 [Generic]
VA App Less State Required Point of Sale Disclosure - 41058 [VA]
VA App Less State Required Point of Sale Disclosure - 41058PA [PA]
Variable Annuity Annuitization Request - 40556
Variable Annuity Annuitization Request - 40556NY [NY]
Variable Annuity App Supplement - 15351A
Variable Annuity Application Supplement - GLICNY - 15351ANY [NY]
Variable Annuity Forms Packet - 46364 [Generic]
Variable Annuity Forms Packet - 46364NY [NY]
Variable Annuity Forms Packet - 46364R [Multi-State]
Variable Annuity New Business NIGO Checklist - 47552
Variable Annuity Portfolio Rebalancing Form - Chase - 16448CBNY [NY]
Variable Annuity Questionnaire - 39028 [NC]
Variable Annuity Systematic Withdrawal Request - 13583 [Generic]
Variable Annuity Systematic Withdrawal Request - 13583GLICNY [NY]
Variable Annuity Terminal Illness/Medical Facility Surrender Waiver Request - 49073
Variable Annuity Transfer of Investments Form - 43554
Variable Products Rep Telephone and Electronic Transfer Auth - 13656NY [NY]
Voluntary Election for Systematic Resets - 39550CBNY [NY]
Voluntary Election for Systematic Resets - Chase - 39550CB [Multi-State]
W-4P Withholding for Annuity Payments - W4PANNNY [NY]
W4P Withholding Form For Annuity Payments - UFLIC - W4P-ANNUFL
W4P Withholding Form For Annuity Payments - W4P-ANN
Withdrawal Authorization for Fixed Annuities - 43952RMDFA
Withdrawal Authorization for Fixed Annuities - 43952WFA
Withdrawal Authorization for Variable Annuities - 43954RMDVA
Withdrawal Authorization for Variable Annuities - 43954VA
