Annuity Application

  • Start Your Secure Annuity Application

  • We know annuity applications can feel personal. Insurance companies require certain financial information to verify your identity, help prevent fraud, and confirm the annuity is appropriate for your situation.

    This secure application usually takes about 10–15 minutes and is protected by 256-bit encryption and two-factor authentication. Your information is private, used only for your application, and never sold or shared for marketing.

    If you are unsure about an answer, just provide your best estimate. You can make changes later, and nothing is submitted without your final review and approval.

     Not ready to complete the online application yet? You can schedule a call with Scott Brooks, CFP®, owner of Annuity Resources, LLC,  and ask any questions before moving forward. 

  •  You can either complete the application online below or preview/download the PDF to complete it offline.

    Prefer to review the full application first? 

    Preview or download the PDF to see all questions in advance. You can also print it, complete it offline, and return it later if that is easier.

    Already completed the PDF?
    Upload it here.

  • Step 1 of 7 - Basic Information (2-3 Minutes)

    We begin with some basic information to verify your identity and begin preparing your annuity application.
  • Do you rent or own your current residence?*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • How do you prefer we contact you with updates?
  • Best time to reach you (optional)
  • Date Of Birth*
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  • Gender*
  • What's your marital status?*
  • Do you have dependents?*
  • What is your residency status?*
  • What is your current employment status?*

  • Great — let’s move on to your investment details.

  • Step 2 of 7 — Investment Details (2-4 minutes)

    These questions confirm the annuity product, term, and funding source you are interested in so we can prepare the correct application paperwork.
  • What term (2-10 years) are you interested in?*
  • What type of account are you setting up? (select one)*
  • Funding source - Where is the money coming from?*
  • Are there any surrender charges, penalties, or fees of any kind if you move the money from this source?*

  • Perfect — now let’s review your financial snapshot. 

  • Step 3 of 7 — Financial Snapshot (4–5 minutes)

    This quick overview helps ensure the annuity fits your financial situation and goals. Estimates are perfectly fine — you can update these later if needed.

  • Part 1 - Investments You Currently Own

  • Which of the following investments do you currently own?(Select all that apply)*

  • Part 2 — Investment Experience

  • How would you rate your investment knowledge?*

  • Part 3 — Income and Taxes

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  • What federal income tax bracket are you in?
  • What's your tax filing status?

  • Part 4 — Monthly Expenses and Debt

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  • Part 5 — Other Assets You Own (Not Being Used for This Annuity)

  • Please list assets you own outside of the money being used for this application. Estimates are fine. Please do not count the same asset twice. 

    Do not include:

    • Funds being used for this annuity
    • Existing annuities already listed in the Existing Policies section
    • Life insurance cash value already listed elsewhere                                                 
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  • Thanks — this helps ensure the annuity fits your financial situation.

  • Step 4 of 7 — Existing Policies & Experience (1-4 minutes)

    This helps ensure the annuity recommendation fits your current accounts and financial experience. Estimates are perfectly fine — we’ll review the details with you before anything is submitted.

  • You may have already indicated which assets you own above. This section is where you provide the details of any existing annuities or life insurance policies with cash value.

  • Do you currently own any annuities or permanent life insurance with cash value that should be listed below?*
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  • Are you considering using funds from this policy for the annuity?
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  • Got it — next we’ll confirm your income and withdrawal preferences.

  • Step 5 of 7 — Income & Withdrawal Plans (1-2 minutes)

    This helps ensure the annuity is structured to match your income needs and goals. You can update these preferences later if needed.
  • What are your primary goals for this annuity? (Select all that apply)*
  • When do you expect to begin taking distributions from this annuity?*
  • How do you plan on taking withdrawals? (select all that apply)*

  • Great — just a few final questions to complete your application.

  • Step 6 of 7 - Final Suitability Review (2-4 minutes)

    These final questions are required by most insurers to confirm the annuity is suitable and to help protect you from applying for a product that may not fit your situation.
  • How many years do you plan on keeping the annuity?*
  • What is your risk tolerance for this annuity?*
  • Do you have an emergency fund for unexpected expenses?
  • Have the owner or joint owner started taking Social Security?
  • Do you expect any significant changes to your financial situation?
  • Is this intended to replace an annuity you already own?*
  • Do you currently have a reverse mortgage, or are you planning to get one in the next 12 months?*
  • Do you currently live in, or expect to move into, a nursing or assisted living facility within the next 12 months?*
  • Have you been diagnosed with a terminal condition or advised that you have 24 months or less to live?
  • Please confirm the following (check all 3):*

  • You’re almost done — these final questions help confirm everything is set up correctly.

  • Step 7 of 7 — Final Step: Protecting Your Beneficiaries & Identity Verification (1–3 minutes)

    You’re almost done — this final step helps protect you and your beneficiaries and allows us to prepare your application.
  • Would you like to add beneficiary information now?
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  • Will there be a joint owner on this annuity?*
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  • Questions or additional details (optional)

    If you have any questions or would like to share anything else, let us know — we’ll follow up within 1 business day.

  • Front Of Driver's License or Passport

    A copy of the front of your driver’s license or passport is required to verify your identity. You may take a photo with your phone, computer, or tablet, or upload an existing image from your device. If you prefer, you can also provide your ID later.
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  • You’re all set — just one final step to complete your application. You’ll review and approve everything before anything is submitted to the insurance company.

  • By clicking “Submit,” you agree that Annuity Resources may contact you regarding your application by phone, text, or email. Message and data rates may apply.

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