ANNUITY SUITABILITY
First Name
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Last Name
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Email
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Phone
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Date of Birth
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State of Residence
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Spouse's Name (N/A if none)
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Spouse's Date of Birth (skip if none)
Total Investment/ Savings Portfolio
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Where are the funds located?
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Traditional IRA
Roth IRA
401 K
Lump-Sum Cash or Pension
Non Spousal IRA
403 B
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Your Retirement Status (Time until Retirement)
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Your Retirement Status*
5 or more years until Retirement
2 - 5 years
Less than 2 years
Currently Retired
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Spouse's Retirement Status (Time until Retirement - N/A if none)
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Spouse's Retirement Status*
5 or more years until Retirement
2 - 5 years
Less than 2 years
Currently Retired
N/A
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Retirement Concerns
Loss in Stocks/ Investment
Paying too much in Taxes
No Guaranteed Income
Outliving Income
Paying too much in Fees
This would be a transfer from an Employment-Sponsored Plan
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Yes
No
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If savings already invested & withdrawing, current Monthly Withdrawal Amount (0 if none)
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If no current Withdrawals - What age do you anticipate beginning withdrawals? (N/A if already withdrawing)
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