Your Full Name:

Phone**:

Your Spouse's (Partner's) Full Name:

Leave blank if N/A

Fax:

Address:

Street

City

Province

Postal Code

Email**:

** In order for us to provide you with an annuity quotation, you will need to enter your email address and/or your phone number. 

Your email address is not submitted to us unless you enter it in the form.

Calculate the required income, given the lump sum deposit amount?  

or

Calculate the lump sum deposit amount, given the required income?   

**Annuity Amount:

**Marginal Tax Rate  - Click Here for the Marginal Tax Rate Calculator

%

**Please choose the type of annuity.

Please Choose... Single Life Annuity Joint and Survivor Life Annuity Term Certain Annuity

There are 3 basic types of annuities

• Single Life Annuity - this type of annuity will pay you for your lifetime regardless of how long you live.

• Joint and Survivor Life Annuity - this type of annuity will pay for the lifetime of a couple, regardless of how long at least one of the annuitants is alive.

• Term Certain Annuity - this type of annuity will pay for a specified period of time at which time all of the principal and interest have been paid. NOTE** - Term Certain Annuities can NOT be used with Registered Funds such as RRSPs, RRIFs, or LIFs unless the Term Certain Period is to Age 90. 

• For Registered Annuities, most often a Life Annuity will be used.  If you want the annuity to pay for at least a minimum period due to a premature death, please choose a "Number of Years to be Guaranteed" below

**Please choose the source of these funds.

Please Choose... Non-registered RRSP RRIF LIF LIRA LRIF LRRSP RPP PRIF DPSP

**Do you want the capital preserved for your heirs?:

(for non-registered funds)  Yes No

If you answer no, then specify below how many years you would like to guarantee that your payments be made.  ie: 5, 10, 15 yrs. etc

NOTE:  If you want the capital to be preserved, you must be in good health in order to acquire the life insurance that replaces the capital at death.

Please choose the guarantee payment period from the drop down menu.  For Insured Annuity Quotes, a 0-year or 1-year guarantee period is normally used in order  to maximize income, unless you request a longer period.

The maximum guarantee payment period is to age 90.  The life annuity will, however, continue to pay for as long as you live.

NOTE: The latest deposit date can be no later than December 31 of the following Calendar Year from the date of the deposit.

ie. If today's date is December 1, 2009, your latest deposit date can not be later than December 31, 2010.

Month... JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovember December Day... 123456789101112131415161718192021222324252627282930 31 2009 2010 2011 2012

NOTE: The latest date that payments must begin is no later than December 28 of the year following the deposit.

ie. If you make a deposit on July 1st, 2009, your first payment date can be no later than December 28, 2010.

Month... JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovember December Day... 12345678910111213141516171819202122232425262728 2009 2010 2011 2012

**Payment Frequency

Monthly Quarterly Semi-Annual Annual

If you require two single life quotes, please submit the information separately. 

** Required Information

NOTE:  If you want to replace capital at death and if one of the two spouses is in poor health, the strategy is just as effective on one spouse, which can still greatly enhance your retirement income.

Last Name:

Gender:

Male Female

First Name:

Date of Birth:

January February March April May June July August September October November December

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Any health or lifestyle issues?

Smoker:

Yes No

Last Name:

Gender:

Female Male

First Name:

Date of Birth:

January February March April May June July August September October November December

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

1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970

Any health or lifestyle issues?

Smoker:

Yes No