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SPIA Request

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SPIA Request

SPIA Request

Please provide us with the information below in order to receive an annuity illustration. We’ll run the most competitive rates and get you the results by the next business day.

SPIA Request Form

Agent Information
Agent Name *
Email *
Phone *
Primary Annuitant
Name *
Gender *
MaleFemale
Date of birth *
State *
Secondary Annuitant (if applicable)
Name
Gender
MaleFemale
Date of birth
Quote Information
Payout Type (Check all that apply) *
Life onlyLife with Cash RefundLife with Installment RefundLife with Period CertainPeriod Certain only
Number of period certain years
Solve for *
Single Premium DepositIncome Payment
Premium or Income desired *
Payment Frequency *
MonthlyAnnualQuarterlySemi-Annual
Fund Type *
Non-QualifiedQualified
Cost Basis (if applicable)
Date payments to begin (default is one modal period)
Anything we missed?
Any other information you feel is pertinent, please list here.

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Contact Us

Lenz Financial Group
5550 S Macadam Ave. #230
Portland, OR 97239
Office 503.222.3924
Fax 503.229.1867
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DISCLAIMER
_{This website and all of its contents here under, are strictly for the use of AGENTS LICENSED WITH Lenz Financial Group. This site is NOT FOR CONSUMER USE. The materials contained in this site are a conglomeration of information made available to Lenz Financial Group, by insurance companies, as well as Lenz Financial Group's analysis and summary of products.
The purpose of the information provided on this site is to provide Lenz Financial Group's Agents with a quick guide to products available at Lenz Financial Group.}

_{While Lenz Financial Group makes every effort to maintain the accuracy of information provided on this site, Lenz Financial Group DOES NOT GUARANTEE the accuracy of information provided on this site and is NOT RESPONSIBLE FOR ERRORS AND OMISSIONS. All information should be verified with Lenz Financial Group by the Agent using this site.}

_{Securities offered through
The Leaders Group, Inc.
( Member FINRA/SIPC )
26 W. Dry Creek Circle, Suite 800

Littleton, CO 80120, 303-797-9080.
Lenz Financial Group is not affiliated with The Leaders Group, Inc.

FINRA

SIPC}

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