Annuity Audit Review

The information below and a current policy statement is necessary for a complete review of your
policy and to help us determine the best possible options to consider.

info@annuityauditreview.com

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Owner, if Different than Annuitant: *

First

Last

Date of Birth

Annuitant #1 Name: *

First

Last

Date of Birth:

Annuitant #2 Name: *

First

Last

Date of Birth

State of Sale:

Current State of Residence:

Policy Number:

Issue Date:

Company:

Objective at Original Purchase:

Policy Type:

• Variable Annuity (VA)
• Fixed Annuity (FA)
• Fixed Indexed Annuity (FIA)

Account Value:

Is this Annuity Qualified or Non-Qualified?

• Qualified
• Non-Qualified

Income Rider:

• Yes
• No

If yes, has income started?

• Yes
• No

Objective for Annuity Today:

• Accumulation
• Income
• Long-Term Care

If Income:

• Single Payout
• Joint Payout

If Joint Payout, Spouse Date of Birth:

Income Deferral Period (When Should Income Start):

Type: Objective started?

Other Considerations

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