EX-99.27(D)(17) 4 vmii-html6221_ex27d17.htm CERTIFICATE E-CHNAME-21

Exhibit 27(d)(17)

 

Voya Retirement Insurance and Annuity Company

 

CONTRACT HOLDER NAME CHANGE ENDORSEMENT

 

This Endorsement is made a part of the Contract and, if applicable, the Certificate to which it is attached:

 

Contract Holder: [Current Name]

 

Group Contract Number: [Specimen]

 

[Certificate Holder: [Participant Name]]

 

[Certificate Number: [Specimen]]

 

The Contract and, if applicable, Certificate, is hereby endorsed as follows:

 

The name of the Contract Holder is changed to [New Name].

 

The effective date for this endorsement is [the date this endorsement is accepted by the Contract Holder].

 

  [
   
 

President]

 

Voya Retirement Insurance and Annuity Company

 

 

[Accepted for:

 

 

Contract Holder Name:

 

 

  Signed By:  
      Name:  
      Title:  

       
    Date: ]

 

E-CHNAME-21