Quote Questionnaire
First select the company you prefer and then select the annuity product from the drop-down list located below the companies. Please note that not all annuities are available in all states, therefore if you choose an annuity not available in your state, we will substitute information and a kit for one that is as close to your choice as is available.
If you would prefer to have our professional advice on the company and annuity that would best fit your circumstances based on your answers on this page, click on the "Choose the best one for me" selection.
AIG/Anchor National
AIG/Sun America
Allstate
American Skandia
AXA-Equitable Life
First Colony
Genworth
(GE Life & Annuity)
Hartford/Planco
ING/Aetna
ING/Golden American
ING/Reliastar
ING/USG Annuity
Integrity Life
Jackson National Life
Jefferson Pilot
John Hancock Funds
John Hancock
(formerly Manulife)
Lincoln Benefit
Lincoln Life
Mass Mutual
MetLife Investors
MetLife/New England
Nationwide/BOA
Nationwide Life
New York Life
Ohio National
Pacific Life
Penn Mutual Life
Phoenix Life
Prudential
Putnam-Allstate
Putnam-Hartford Annuities
Scudder
Sun Life Financial
Sun Life of Canada
Sun Life-Keyport
Symetra
(formerly Safeco)
Transamerica Capital
Travelers Life & Annuity
Please first select a company from above
Fields marked with (*) are required.
Please select one*:
Send via email
Phone prior to sending
First Name*
Last Name
Phone Number* (
)
-
(In case we need to clarify any information)
Email Address*
Participant Information
Name of the purchaser (owner) of the annuity*
Owner's date of birth*
--Select--
January
February
March
April
May
June
July
August
September
October
November
December
--Select--
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
--Select--
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
Owner's state of residence*
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Owner's sex*
--Select--
Male
Female
(Click here if owner and annuitant are the same person )
Name of person who will be the annuitant.*
(Usually the same as the owner.)
Annuitant's date of birth*
--Select--
January
February
March
April
May
June
July
August
September
October
November
December
--Select--
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
--Select--
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
(if different from the owner)
Annuitant's state of residence*
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
(if different from the owner)
Annuitant's sex*
--Select--
Male
Female
(if different from the owner)
Name of the person(s) who will be the primary beneficiary.
(This is who will receive the annuity in the event of the annuitant's death.)
Annuity Information
Dollar amount of your deposit for which you want a quote.*
Are the funds Qualified or Non-Qualified?*
--Select--
Qualified
Non-Qualified
Unsure
(Qualifed is from an IRA, pension plan, etc.)
Is this a Rollover?*
--Select--
Yes
No
Unsure
(Rollover is from another annuity/1035 exchange)
Which type of annuity would you prefer:*
--Select--
Fixed Annuity (Traditional)
Fixed Annuity (Indexed)
Variable Annuity
Unsure
[click for description: fixed vs. variable ]
Select those benefits that are important to you: *
(Not all benefits are available in all states or with all annuities)
Lifetime Income Benefit (LIB) (click for more info)
Guaranteed Minimum Income Benefit (GMIB) (click for more info)
Guaranteed Minimum Accumulation Benefit (GMAB) (click for more info)
Guaranteed Minumum Withdrawal Benefit (GMWB) (click for more info)
Guaranteed Lifetime Withdrawal Benefit (GLWB) (click for more info)
Shortest possible surrender fee period
Account Value Step Up Benefit
Dollar Cost Averaging Benefit
Automatic Asset Rebalancing Benefit
None
Other (please specify):
Timeline for annuity purchase*
--Select--
Within 30 days
30-60 days
Less than 6 months
More than 6 months
When would you like to begin receiving regular income payments from the annuity?*
--Select--
Immediately (Not available with Indexed Annuities)
Within a year
1-5 years
5-10 years
Longer than 10 years
Purpose of this annuity (and comments or questions)*
Before investing, investors should carefully consider the investment objectives, risks, charges and expenses of the variable product and its underlying investment options. The current contract prospectus and underlying fund prospectuses, which are contained in the same document, provide this and other important information. Please contact your representative or the Company to obtain the prospectuses. Please read the prospectuses carefully before investing or sending money.