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    Immediate, Lifetime, Fixed and Complying Annuities Order Form
It is easy to request a quote for Annuities including Complying Annuities.

Please complete the form and hit the Submit button and we will find the best quote from our panel of insurers.  We will then contact you with the result of the quotation and mail the winning insurer's Product Disclosure Statement.
 

Applicant's Title:
 


 

First Name:
 

 
Surname:
 

 
Address Line 1:
 

 
Town / Suburb:
 

 
State:
 

 
Postcode:
 

 
Phone Number:
 

 
Email Address:
 

 
Your Sex:
 

 
Your Date of Birth:
 
Year
 
Payee Type:
 

 
If reversionary state reversionary percentage:
 
%
 
If you selected Joint Annuity or Reversionary please complete your partner's details:
 
 
Partner's Title:
 

 
First Name:
 

 
Surname:
 

 
Partner's Sex:
 

 
Partner's Date of Birth:

Complete details of your required Annuity:
 

Year
 
Select Annuity Term:
 

 
If Lifetime state Guarantee Period (if any): years
 
If Fixed Term state Term:
 
years
 
If Fixed Term state Residual Capital Value (if any): %
 
Do you require indexation on your annuity payments?:
 
If yes, specify amount:
 
state an amount up to 5% or "CPI" for CPI indexation
 
Select Payment Frequency:
 

 
Do you require a Complying Annuity?:
 
Will you be purchasing the Annuity with Superannuation Money (ETP)?:
 

 
State the Total Annuity Purchase Amount:  $
 
Comments or
 Special Requests: