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Fixed Index Annuity Request
Please complete all entries to receive a customized illustration within 12 hours or less (usually within 1 hour!)
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Email
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First Name
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Last Name
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Your answer
Date of Birth
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DD
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YYYY
Telephone Number
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Address
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City
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State
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Zip
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Marital Status
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Single
Married
Divorced
Separated
Widowed
Unmarried Long-Term-Relationship
Number of children
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Your answer
Age Range Of Children if Any
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0-12
12-18
18-22
22+
I do not have children
Amount to invest NOW
*
Your answer
Attitude Toward Risk
*
I want a guaranteed annual interest rate, no more, no less.
I want to participate if the market goes up, but never lose money if the market goes down
I want to exceed the general market returns, and if my balance declines by 1 or 2 percent in a bad year, That's OK
Overall Investment Portfolio Balance
*
$20000-$100,000
$100,001-$500,000
$500,001-$1,000,000
$1,000,001-$5,000,000
$5,000,001-$10,000,000
$10,000,001+
Time Frame for this investment
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This Month
Next Month
3-6 Months
6-12 Months
Please share any information about your financial situation or plans you feel comfortable sharing.
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