First Name: Joe

Last Name: Biden

Street Address: 111 Presidential Lane

City: Washington D.C.

State: Washington D.C

b 12345

Day Phone: 123-123-1234

Evening Phone: 123-123-1234

E-mail Address: joebidenrocks@yahoo.com

Best time to call: 8-10 a.m.

Who is this quote for? Me

Gender: Male

Birthday (mm/dd/yy): 01/01/56

Your tax bracket: 15%

Amount of money you want to invest (note, $5,000 is a typical minimum): $5,000

If this is not a lump sum investment, how much do you plan to add to the annuity? $5,000

How often will you deposit additional funds? Quarterly

If any funds are coming from a Tax Qualified account, what type of account is it? (leave blank if irrelevant)

If any funds are coming from a Non-Tax Qualified account, what type of account is it? (leave blank if irrelevant)

If funds are coming from a CD, what month does it come due? Not from CD

Primary consideration influencing annuity purchase: Tax-deferral

Other consideration influencing annuity purchase: Company offering annuity

How long would you like your annuity to grow before receiving income payments? To Age 76

Would you like an additional quote for any of the following insurance products?

Life Insurance ()
Disability Insurance ()
Long Term Care Insurance (yes)
Health Insurance ()
Group Health Insurance ()
Auto Insurance ()
Homeowners Insurance (yes)
Home Loans ()