ANNUITY QUOTE INFORMATION

Annuities are designed to meet long-term goals such as retirement and the earnings typically accumulate tax deferred.

For more information about annuities and how they may apply to your individual financial situation, please consult your financial representative and/or your tax

After completing the form, please click on the "Submit" button. Your information will be emailed to our offices and we will process your request. All information will be kept confidential.

Name

First NameLast Name

Email

example@example.com

DOB or Age*

State

Best phone number to call 9AM to 7 PM

Best Time of Day to call

9AM to 12PM12 PM to 5PMAfter 5PM

All Fixed and Fixed Index Annuites we offer provide tax deferral and principal protection. Please select other features that would be attractive to you:

Competetive return to other safe investmentsCompetetive returns linked to the Stock MarketGuaranteed income for lifeGuaranteed income for both myself and my spouseIncreased (up to two times) income for health careLeaving a legacy

Will the funds come from another annuity?

YesNo

Will there be any surrender charges or penalties for moving your funds from current position?

YesNo

Approximate amount of Investment

Income needs from annuity

NoneNowLaterInterest only

Age you will take guaranteed income or interest

Joint Income needed?

YesNoNA

Spouse Name

First NameLast Name

Spouse DOB or Age

I have other assets I may want to look at other portfolio choices.

YesNoMaybe

Securities and Advisor Services offered through Silver Oak Securities, Inc. Member FINRA / SIPC Hearn Wealth Management and Silver Oak Securities Inc are not affiliated/separate entities. Martin Hearn RFC Investment Advisor Representative DBA Hearn Wealth Management LLC

Annuities are long-term investments designed for retirement purposes. The value of variable annuities is subject to market risk and will fluctuate. Product guarantees are subject to the claims-paying ability of the issuing insurance company. Earnings, when withdrawn, are subject to federal and/or state income tax, including a 10% tax penalty for withdrawals before age 591/2. Some income guarantees offered with annuities take the form of optional riders and carry charges in addition to the fees and charges associated with annuity products. There is no guarantee that any investment will achieve its objectives, generate positive returns, or avoid losses. Investments in annuity contracts may not be suitable for all investors.

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Will the funds be coming from a 401K, TSP, IRA, or other qualified source?

YesNo

ANNUITY QUOTE INFORMATION

901 473-9379 or 877 Hearnwm