EX-99.(E)(13) 9 viaca-html7897_ex99e13.htm FORM OF CONTRACT ASSUMPTION & TRANSFER RESPONSE FORM

 

Exhibit 99(e)(13) – (Item 27(e)(13)) Form of Contract Assumption/Transfer Response Form

 

[Equitable Mark]

 

Mail To:

Equitable

[Retirement Service Solutions

P.O. Box 1016

Charlotte, NC 28201-1016]

Equitable Financial Life Insurance Company www.equitable.com For Assistance Call [(XXX) XXX-XXXX]

 

CONTRACT ASSUMPTION/TRANSFER RESPONSE FORM

 

To: Equitable Financial Life Insurance Company
   
Re: Accumulator Contract Number [INSERT CONTRACT NUMBER]


Yes, I accept the transfer of my variable annuity contract referenced above from Equitable Financial Life Insurance Company to Venerable Insurance and Annuity Company.
No, I reject the proposed transfer of my annuity contract referenced above from Equitable Financial Life Insurance Company to Venerable Insurance and Annuity Company.

 

         
  CONTRACT OWNER’S SIGNATURE   DATE  
         
         
  CONTRACT OWNER’S NAME      
         
  For Contracts with more than one owner:      
         
         
  JOINT OWNER’S SIGNATURE   DATE  
         
         
  JOINT OWNER’S NAME      
         

  

[For Internal Use Only

Jointly owned contract: [Y/N]

Novation Jurisdiction: [insert applicable state for the contract] ]

2023VCNSNTNovation Response Form – VIAC