Immediate annuity quote formImmediate annuity quotes - for agents - Income quotes and commissions!
We compare a dozen immediate annuity quotes and commissions for our insurance agents.
The income annuity general agency for the independent life agent. 
See what Over 35 Years Experience has to offer!
In order to complete this immediate annuity quote
We must have the annuitants age, gender, state of issue, premium amount, source of funds & agent info.
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Immediate Annuity Quote Request Form - Agents ONLY!
Custom immediate annuity quote spreadsheets by PDF, Email, Fax or even html.
Please fill in as much information as possible for this quote to be accurate.

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

Joint Annuitant Information (if any):
Name:     Male   Female
Date of birth:  Age:   State: 

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

Deposit Amount: $
Desired Income: $
1035 Cost Basis  $

Deposit Date: Month Day Year

Income Start in: Month Day Year

Annuity Payment Frequency:
Monthly Semi-Annually Quarterly Annually

Type of Immediate Annuity - Select options from below:
 Poor health client? Impaired risk quotes available. May increase payout!
SINGLE LIFE
Life Only
Life With period certain of:
      5 Year 10 Years 15 Years 20 Years 
      Specific: and   Months
Life With Installment Refund 
Life With Cash Refund (low company availability)

JOINT LIFE
Joint & Survivor Lives ONLY
Joint With period certain of:
    5 Year 10 Years 15 Years 20 Years   
    Specific: and   Months
Joint Percent To Survivor (Use Ctrl to highlight more than one)

Period Certain ONLY
   Period Certain Only for:
     5 Year 10 Years 15 Years 20 Years
     Specific:   and Months

Annual Inflation COLA:

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 comments - Special quote requests:

 
FSD constantly shops the insurance market place for the most competitive Single Premium Immediate Annuity quote prices. We have over a dozen Immediate Annuity carriers who at any time may have the most competitive quote price. No one company has the best price for all immediate annuity buyers, some are better at Life Contingency some at Joint & Survivor and so on. One call to us and you can be sure you are receiving the most competitive quote pricing from a top rated carrier.
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