Definitely request an immediate annuity SPIA quote from us before you decide on a lifetime!


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Working with immediate annuities everyday for 20 years!
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Owner/Annuitant Information:


Gender: Male  Female
  Age:  "
Spouse or Joint Life (if any):


Gender: Male   Female
Yes No
Source and Amount of Premium:

Non- Qualified (Cash, 1035 exchange etc.)
Qualified (Ira, 401K rollover, Pension etc.)

Premium Amount: $
Desired Income Amount: $


Deposit Date:
Month Day Year

Income Start: Month Day Year

Annuity Payment Frequency:
Monthly Semi-Annually Quarterly Annually

Annual Inflation Protection (COLA):

What Type of Income Annuity Do You Want
We will quote several options including full refund based on the benefit you choose.

Single Life Options - For as long as one is alive. 

Joint Lives - For as long as either of two are alive. 

Period Certain ONLY - Not a life based payment, just a specific guaranteed period of payments.
     Enter Term 5-30 years: separate with comma for multi years 05, 10 , 20 ect.

How Should We Send Your Quote

Email:   required
Name: if other than owner/annuitant.
Phone: Appreciated

Is quote for a licensed Life Insurance Agent?

Email Adobe Acrobat PDF  
Email Text
Phone Call

Please use the comment for any special requests that do not appear on the form.
Comments - Requests - Referred By:

Toll Free: 800-373-9697
A domain of FSD Financial Services - CA Insurance License # 0B67385 and 0B91910
Copyright 2018 - Last modified: 10/08/2018 Terms Of Use

Earnings and pre-tax premium payments are subject to income tax at withdrawal. Withdrawals prior to age 59 are generally subject to a 10% IRS penalty tax. 
FSD Financial Services does not offer tax advice. For specific tax information, consult your attorney or tax advisor. Product and feature availability, as well as benefit provisions can vary by state.