Deferred Annuity Quote Request For Agents
Illustrations and commissions!

Owner Information:
Name:
Age:  
State:

Male
Female

Annuitant Information (if different ):
Name:  
Age:  
State:

Male
Female
 
Select MYGA interest rate guarantee period (s):
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 other features you need: (optional)
 

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

Initial Premium Deposit Amount: $
Flex Premium (if any)? $

Flex Payment Frequency (for flex):
Monthly
Semi-Annually
Quarterly
Annually

 Deposit Date: Month Day Year

Agent Email: required
Agent Phone: Appreciated
Signing Agent:   required

Receive annuity quotes by:
Email Adobe Acrobat PDF 
Email Text
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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