Intake form

Name *

Email address *

What is your current age?

What type of annuity do you currently hold?

Please select at least one option.

Fixed Annuity

Variable Annuity

Indexed Annuity

Immediate Annuity

Deferred Annuity

What is your primary goal with your annuity?

Please select at least one option.

Income Generation

Tax Deferral

Wealth Transfer

Investment Growth

Retirement Planning

How did you hear about us?

What is your preferred method of communication?

Please select at least one option.

Phone

Email

Video Call

In-Person Meeting

What is your current financial situation?

Are you working with a financial advisor?

What specific questions do you have regarding your annuity?

Additional questions or comments

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