Preliminary Annuity Application

Owners First Name

Last Name

Gender

Date of Birth

Phone Number

Street Address

City

State

Zip Code

Joint Owner First Name

Last Name

Gender

Date of Birth

Relationship to Owner

Phone Number

Street Address

City

State

Zip Code

Primary Beneficiary

Date of Birth

Relationship to Owner

Percent

Primary Benificiary #2

Date of Birth

Relationship to Owner

Percent

Contingent Beneficiary

Date of Birth

Relationship to Owner

Percent

Investment Amount

Annual Income (Gross)

Monthly Living Expenses

In considering this product, what is your risk tolerance?

Conservative - Low Risk: I want to preserve minimal risk, even if that means the account does not generate significant returns. Moderate - Medium Risk: I am willing to accept some risk for a higher return, even if that means losing some principal. Aggressive - High Risk: I am willing to accept maximum risk to seek maximum returns.

Liquid Net Worth

Emergency Funds

Sournce of Funds

Rollover 1035 Checking/ Savings Brokerage Account

Are You Replacing Existing Annuity?

Yes No

Tax Qualification Status

Traditional IRA Roth IRA Non-Qualified

Does This Represent More Than 50% of Your Liquid Net Worth?

Yes No

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Frequently Asked Questions

Is there a fee for your services?

My Annuity Store does not charge a fee for any of our services. 100% of your funds will be invested in your annuity.

How does My Annuity Store get paid?

We are compensated directly by the insurance company in the form of a commission. The commission is paid to us as a percentage of your initial annuity deposit.

Our compensation varies based on the product; however, 2.78% was our average compensation in 2022.

Do you sell my information to other advisors?

No. We do not sell leads, use affiliate links or display any third-party advertisements on our website. We are 100% independently owned and you will work with Kiara, Ryan, or Jason.

How do I buy an annuity at My Annuity Store?

Buying an annuity online at My Annuity Store takes only 3 steps:

Step 1: Learn about annuities and get annuity quotes.

Step 2: Complete your application.

Step 3: Schedule a call to review your desired annuity and finalize application.

You can fund your annuity via:

check
1035
direct transfer/ rollover
ACH
wire

How do you make your annuity recomendations?

We use industry-leading software that allows us to quote and compare 95 insurance companies in real-time. We also lean on more than 40 years of combined annuity experience.