Immediate annuity quote formDeferred annuity quotes - for agents - Illustrations and commissions!
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Deferred Annuities
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Deferred Annuity Quote Request Form - Agents ONLY!

Owner Information:
Name:    Male  Female
Date of birth:  Age:   State:

Annuitant Information (if different ):
Name:     Male   Female
Date of birth:  Age:   State: 
 
 Select an interest rate/surrender term 1-10 years:
1 Year 2 Year 3 Year 4 Year 5 Year
6 Year 7 Year  8 Year  9 Year  10 Year 
We will send highest rate for that term unless specified below!     

Specify Product Name, Rate or Commission: (optional)
 

Source of Funds:
 Non- Qualified (cash, 1035 exchange etc.)
Qualified (Ira, 401K rollover, Pension etc.)

Deposit Amount: $
Annual Flex Deposit $

Flex Payment Frequency (if Flex):
Monthly Semi-Annually Quarterly Annually

 Deposit Date: Month Day Year

Agent Email: required
Agent Phone: Appreciated
Agent Fax: If you would like quotes faxed
Signing Agent: required

Receive annuity quotes by:
Email Adobe Acrobat PDF   Email Text
Fax Phone Call

We welcome any feedback on improving this request form.

Agent Special quote requests:

 
FSD constantly shops the insurance market place for the most competitive Single Premium Deferred Annuity quote prices. We have over a 20 Deferred Annuity carriers who at any time may have the most competitive interest rate. No one company has the best rate for all terms, some are better on short term and some at long term and so on. One call to us and you can be sure you are receiving the most competitive guaranteed annuity rate from a top rated carrier.
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Toll Free (800) 373-9697
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