The information you provide will only be used for the purpose of obtaining annuity quotations on your behalf.
Below are some of the highly regarded annuity providers we have used when arranging our customers' annuities.
Name
Title: Mr Mrs Miss Ms * First Name: * Surname: * Email Address:
Contact Details
* Daytime Phone: Evening Phone: Mobile Phone:
Your Address
* House / Flat Number: * Line 1: Line 2: Line 3: * Town / City: County: Postcode:
Pension Scheme Details
*Gross Fund Available: £
Pension Scheme Preferences
Do you require escalation?: - SELECT - Nil 3% 5% RPI Do you require a guaranteed period?: - SELECT - No 5 Years 10 Years When do you want the annuity to start?: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / 1 2 3 4 5 6 7 8 9 10 11 12 / 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 2045 2046 2047 2048 2049 2050 2051 2052 2053 2054 2055 2056 2057 2058 2059 2060 Spouse / partner's pension proportion: - SELECT - Nil 50% 66% 100%
Marital Status: - SELECT - Married Single Widowed Cohabiting
Underwriting Information
Date Of Birth: Gender: Height: Weight: Occupation: Smoker Status: How many manufactured cigarettes do you smoke or how much rolling tobacco do you consume each week? Have you smoked at least 70 manufactured cigarettes or 85g of rolling tobacco per week continuously for the last ten years?
Self
Partner/Spouse
Please add any additional information or questions in the box below. Many people with health and lifestyle related conditions could be eligible for an enhanced annuity, even though they may not feel that they have a serious condition.
The simplest way to assess whether you may qualify for an enhanced annuity is to complete our medical questionnaire. This can be downloaded by clicking this link (this document requires Adobe Reader, which can be downloaded free of charge from Adobe by clicking here)"