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Do you currently have an Annuity Investment?
Yes  No

If yes what kind type of annuity do you have?
Select Fixed Index Immediate Variable Don't Know

If yes what  type of premium payment do you have?
Select Non Qualified Qualified IRA Qualified Non IRA Don't Know

Are you
Male  Female

/ /  

When do you want to purchase an annuity? Immediately Within 1 month 1 month - 3 months 3 months - 6 months Not Sure

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