Purchase Life Annuity Quotations

Please note that a Purchase Life Annuity is funded from your personal savings, as opposed to a pension fund. This form is a single page, however a medical questionnaire will follow if the Impaired Life option is selected.

Section 1: Annuity & Personal Details

Single / Joint Life:      
Amount of contribution£
Indexation
Guarantee Period
Frequency of income payments
Spouse's Benefit
Impaired Life
Your detailsYour dependant's details
Title
If 'other' please specify
Gender
Surname
Forename(s)
Date of birth   (dd/mm/yyyy)   (dd/mm/yyyy)
Smoker Status
Marital Status
Postcode
E-mail address