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annuity details
* Required field to complete form
What is the total value of the funds?
  *  
Please enter the full fund value,
even if you intend to take it as a lump sum
Is 25% tax-free cash to be deducted from the value above?
  *
If applicable, what percentage of your pension would you like to be paid to a surviving partner after your death?
0%
50%
66%
100%
  *
Do you want to protect your pension against inflation?
0% (Level)
5%
3%
RPI
  *
What guaranteed term (if any) would you like?
None
5 Years
10 Years
  *
Do you currently smoke?
No
Yes
  *
If you do smoke or have recently smoked you may be eligible for a higher annuity rate
If you smoke manufactured tobacco products please indicate the average daily level
: Cigarettes
: Cigars
If you smoke rolling tobacco/pipe tobacco please indicate the average weekly level
: grams rolling tobacco
: grams pipe tobacco
Do you currently take any prescription medication for medical conditions?
No
Yes
  *
If you have ANY medical condition or take ANY medication you may be eligible for a higher annuity rate
Current Height
Current Weight
If you take medication for high blood pressure, how many do you take?
If you take medication for high cholesterol, how many do you take?
Do you suffer from any of the following conditions?
How would you like your annuity paid?
  *
Your Full Name (including title):
  *
Building number:
  *
Must be a number
Your Postcode:
  *
This is important as annuity rates are postcode rated
Phone Number:
  *
Please provide a valid contact number in case we have a queries
Best time to call:
Email Address:
  *
Date Of Birth:
  *
Spouses Date Of Birth: