Would you like an illustration?
Would you like to do a rollover/ new policy?
How long would you like the income to last? For my lifetime (single life) For my lifetime and someone else's (joint and survivor) A set period of time (period certain) Lump sum payment/ Immediate
Do you have a planned retirement age?
When would you like income payments to begin?
Amount to invest Less than $100,000 $100,000 $125,000 $150,000 $200,000 $250,000 $300,000 $400,000 $500,000 $600,000 $700,000 $750,000 $800,000 $900,000 $1,000,000 $1,500,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 $10,000,000
Monthly income needed?
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Date of Birth
Household Retirement No Retirement Money Less than $100,000 $100,000 - $250,000 $250,000 - $500,000 $500,000 - $750,000 $750,000 - $1,000,000 Over $1 million
Full Name
Email Address
Phone Number
Do you currently have a policy?
Do you currently have a retirement account?
Would you like to add any riders?
Type of Retirement/ Investment Account? Fixed Annuity Indexed Annuity Variable Annuity Other Annuity Bond Brokerage Account Certificate of Deposit (CD) Keogh Plan Traditional IRA Roth IRA SEP IRA Self-Directed/ Brokerage IRA Spousal IRA Inherited IRA Rollover IRA Other IRA 401a Plan 401k plan 403b plan 457 plan Pension Plan Thrift Savings Plan (TSP) Mutual Fund Exchange-Traded Fund (ETF) Wrap Account Other Account
Current Financial Institution/ Financial Services Professional/ Broker-Dealer
Would you like us to perform a review/ diagnostic of your current plan/ investments?
Carrier Preference? Pacific Life Prudential Allianz Jackson Lincoln Voya TIAA Fidelity Corebridge (AIG) Other
Indexing Option Preferences? Standard & Poor's 500 Index(S&P 500) (Default) Fixed-Rate Strategy BlackRock Endura Index Khatter Financial 🦚 Standard & Rich 500 Index Bloomberg Commodity Index(BCOM) Barclay Hedge Fund Index Dow Jones Industrial Average Index(DJIA) Dow Jones U.S. Real Estate Index(DJUSRE) Goldman Sachs Aging of America Dynamic Balance Index Nasdaq Composite Index(COMP) Russell 2000 Index(RUT) Wilshire Index(W50000) U.S. Dollar Index (USDX) MSCI EAFE Index International Index Other Index
Your risk profile, investment objectives and expected rate of return from investments? (Select all that apply) 3% - 6% Conservative (30% equity, 70% bonds) (Default) 6% - 9% Moderate (60% equity, 40% bonds) 9% + Aggressive (90% equity, 10% bonds)
Growth
Income
Capital Appreciation
Safety
Capital Preservation
Liquidity
Tax Efficient
Dividends
Contact Preference? Phone Call Text Email Zoom Video Other (Put down below in message)
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