(Please Select) 14 Year Term 10 Year Term 9 Year Term 8 Year Term 7 Year Term 6 Year Term 5 year Term 4 year Term   Index Annuity Design:   {Please Select One} I Don't Know which is BEST! Please Recommend the Best 4 Available on the Market for ME to Consider. I ONLY want the S&P 500 Index in my Annuity I want a Choice of up to 3 Equity Indexes I want a Large Choice of Equity Indexes   Bonus Percentage Added to Account on Day One? Bonuses can be viewed as paid in exchange for a Longer-Term commitment. (I understand that for receiving a bonus on day one a trade off may exist over the long-term. That trade off may be in the form of a Lower Participation Rate / CAP Rate / Fixed Interest Rate and a Higher Margin over time. I also understand that a Bonus may work to my benefit under some market conditions {"a bird in hand is worth two in the bush"}.) Therefore I Want an:   {Please Select One} I DO NOT Want a Bonus! I understand the Interest Earned over the long-Term may be materially Higher without a Bonus. 10.00% Bonus on 14 Year Term 10.00% Bonus on 10 Year Term 7.00% Bonus on 10 Year Term I want the Highest Bonus Available (fully earned on day one) Highest Bonus Available for Term of 10 Years OR Less(fully earned on day one)   Option Now Available for NO Annuitization.....LifeTime Income!.....Are You Interested?   NO YES         Amounts You Have Available to Invest?   Available for All Types of Instruments / Products:$   Enter Amount/Lump-Sum you will Deposit: $50 thousand Minimum ..........Up to $2 Million FOR   Each Index Annuity:$  *   How Many Index Annuities Will You Buy? 1 2 3 4 5 or more     Total Value of Your Entire Portfolio:$  *   Please Select the ONE that best describes the Primary Source of Funds for this Index Annuity:   Non-Qualified: (Please Select)InheritanceSale of 2nd 3rd or other HomeSale of other Real EstateInvestment Account (Bonds and/or Stocks)Money MarketSavings AccountChecking AccountMaturing CD'sMaturing Deferred AnnuityVariable AnnuityLife Insurance Cash Value (1035 Exchange)Lawsuit Settlement OR: Qualified (Pre Tax Funds): (Please Select)IRA and IRA Rollovers (Retirement Account)401K (Pension Account)Profit Sharing Plan403b (TSA Account)457 Plan (Pension Account)SEP or Keoh (Pension Account)Defined Benefit Plan Termination or Lump-Sum Settlement (From Pension)   Do You want to Move BOTH Non-Qualified and Qualified Funds (If Yes indicate source for BOTH Above)? NO YES   Will you let Interest Earned Compound and Grow?(If not please explain in comments below.) YES NO   Annuitant Personal Information:   Name (Skip if same as contact person): Gender: (Please Select)MALEFEMALE Date of Birth (mm/dd/year):  * State of Residence:  *   Contact Information:   First Name:  * Middle Initial: Last Name:  * Email Address:  * Re-Enter Email Address:  * DayTime Phone#:  * Home Phone #:  * Address:  * City:  * State:  * Zip Code:  *   Best Time to Call me:   Spouse Information:   Spouse Name: Spouse Gender: (Please Select)MALEFEMALE Spouse Date of Birth (mm/dd/year):   *Other Details: Please Explain your Objectives in more Detail and Provide any other information you think I should know in order to show you the very best Index Annuities on the market for your specific needs: Comments: Objectives and More Detail:     * When Do You Intend to Buy this Index Annuity?   Call me NOW... I am Ready to BUY the Very Best Index Annuity Available ASAP! Right Now (Within 10 Day's) Immediately (Within 3 Weeks) Immediately (Within 4 weeks) In 1 to 2 Months In 3 to 4 Months In 5 to 7 Months In 8 Months to 1 Year Longer than 1 Year Longer than 3 Years   Important Information:   Where Do You INTEND to BUY this Index Annuity?   MOVE from HERE to Select the TRUE Choice...OR...We Will NOT Respond!!! I am already a Client of this Service. I want to meet Face to Face with an Agent or Broker or Advisor. I prefer to Buy Directly (Over Phone & via FedEX) NO Face to Face Meeting. Contact me so we can start the Quote process. I Just want to TALK to you about the very best Index Annuity Options ... Call me. I am the Agent or Broker or Advisor. I intend to buy through an Agent or Broker or Advisor I already know. (Then WHY isn't he/she doing this work for you? You don't trust them to be complete in their search? Do you think they are incompetent? Do you think they present only what is in their best interests to show you? Do you think it's fair that they get paid for our extensive work? We don't!) I am a Trustee or CPA or Attorney.   All information is required in order to provide you with accurate quotes/information and detailed brochures.   All information you provide will be kept confidential.   Do not enter anything in this field:

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