Ask a Specialist : LARC

Agent Name:

Agent Phone Number:

Agent Email:

Client Name:

Age:

Gender:

Male

Female

State:

Spouse Name:

Spouse Age:

Proposed Annuity Amount:

Where is the money coming from:

Do you want RMD's shown on the illustration?:

YES

Is this account coming from an active employment sponsored plan? * Not all employer sponsored plans (Ex. 401(k)) allow in-service distributions. The employee will need to contact the plan administrator to determine if the employer’s plan allows in-service distributions.

YES

Please select the following statement that best describes your clients primary goal:

Is the client currently taking withdraws/income from this account? If so, how much?:

If not taking withdraws/income, at what age does the client anticipate taking withdraws/income? *If not planning on taking or already taking income, write "n/a":

Additional Comments:

Attachment 1:

Attachment 2:

Attachment 3:

Ask a Specialist.