Immediate Annuity Experts
Guaranteed Income For Life - Call Us 800-373-9697

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Welcome to our guaranteed income quote request form:

Since 1995 we have shopped the fixed annuity marketplace to find the best pay-out with the strongest insurance carriers.
Request a no obligation quote below or see some Example Immediate Annuity Quotes to get an idea of your guaranteed income amount.

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Annuitant Information:*
Name:   
Male  Female
D.O.B.  Age:   State:

Joint Annuitant Information (if any):
Name:
   
Male   Female
D.O.B:
 Age:   State: 

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

Deposit Amount: $ *
Desired Income: $
1035 Cost Basis  $ (Original Deposits)

Deposit Date: Month Day Year *

Income Start: Month Day Year *

Annuity Payment Frequency: *
Monthly Semi-Annually Quarterly Annually

Type of Immediate Annuity:
SINGLE LIFE
Life Only
Life With period certain of:
     
5 Year 10 Years 15 Years 20 Years 
      Other:
Years and   Months
Life With Installment Refund 
Life With Cash Refund (low availability / none joint lives)

Joint Lives
Joint & Survivor Lives ONLY
Joint With period certain of:
    5 Year 10 Years 15 Years 20 Years
   
    Other:
Years and   Months
Joint Percent To Survivor

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

Other:   Years and Months

Poor health? Should try an impaired risk quote.

Annual Inflation COLA:

Email: required*
Name: if other than annuitant.
Phone: Appreciated
Fax: If you would like quotes faxed

Receive quotes by:
Email Acrobat PDF   Email Text
Fax Phone Call

Please use the below for any special requests that do not appear on the form.
Additional questions: Feel free to call 800-373-9697

Send mail to jeff@spiaquote.com with questions or comments about this web site.
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Last modified: 09/18/2008
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