Please complete the form below and your annuity quotation will be emailed to you. Quotes are available to UK citizens only
All information is submitted in strict confidence and you are never under any obligation to proceed.
The impaired or enhanced annuity quotes we provide do not represent personalised advice and are not a recommendation that any product matches your circumstances. If you should have any doubts please contact an independent financial adviser so that your individual circumstances can be considered.
Your Details
Your Full Name
Address
Telephone Number
Email Address
Date of Birth dd/mm/yyyy
Do you smoke
Yes
No
If yes, type of tobacco smoked
How long have you smoked
Amount smoked per day
Height
Weight
Marital Status
Occupation
Full time
Part time
Previous Occupation if no longer working
Summary of your Medical Conditions
CONDITION 1
Date Diagnosed
Any Specialist Investigation
Treatment and Medications Taken including Daily Dosages.
CONDITION 2
Date Diagnosed
Any Specialist Investigation
Treatment and Medications Taken including Daily Dosages.
CONDITION 3
Date Diagnosed
Any Specialist Investigation
Treatment and Medications Taken including Daily Dosages.
Spouse Details - For Joint Applications
Spouse Full Name
Address
Date of Birth dd/mm/yyyy
Do you smoke
Yes
No
If yes, type of tobacco smoked
How long have you smoked
Amount smoked per day
Height
Weight
Occupation
Previous Occupation if no longer working
Summary of Spouses Medical Conditions
CONDITION 1
Date Diagnosed
Any Specialist Investigation
Treatment and Medications Taken including Daily Dosages.
CONDITION 2
Date Diagnosed
Any Specialist Investigation
Treatment and Medications Taken including Daily Dosages.
CONDITION 3
Date Diagnosed
Any Specialist Investigation
Treatment and Medications Taken including Daily Dosages.
Pension Annuity Details (using funds from a pension plan)
Total amount of Pension Fund after deduction of Tax Free Cash lump sum if applicable
Total amount of any 'Protected Rights' benefits?
Does this pension provide a 'Guaranteed Annuity Rate'?
Original source of pension fund
Do you require your Annuity to escalate
Do you require the Annuity to have a Minimum Guranteed Period
If you require a spouses pension, what amount do you require to be paid to your spouse on your death? Please ensure spouses details are completed above.
Purchased Life Annuity Details (using your own funds)
Purchased Life Annuities and Immediate Needs Annuities, Lump Sum Available
Do you require your Annuity to escalate
Do you require the Annuity to have a Minimum Guranteed Period
Joint life plans only: if you require a spouses pension, what amount do you require to be paid to your spouse on your death
Please note:
Escalating annuities, Guarantee periods and joint life annuities will result in lower initial annuity income when compared to level, single life annuities with no guarantee.
Any Other Comments
Data Protection Act 1998: By sending this illustration request you consent to the above medical information being used by our annuity providers for the purpose of providing you with an annuity quotation without cost or obligation. Your details are protected by the Data Protection Act and will only be used to complete your annuity quotation.
Or print off and send by post to: Biggerpensions.com Eckington Business Centre 62 Market Street, Eckingtion Derbyshire S21 4JH
Biggerpensions.com is a trading name of Clarity Financial Advice Ltd. Registered in England no. 5615986. Registered Office: Eckington Business Centre, 62 Market Street, Eckington, Derbyshire S21 4JH. Clarity Financial Advice Ltd is an appointed representative of Mint Financial Services Ltd which is authorised and regulated by the Financial Services Authority. Mint Financial Services Ltd is entered on the FSA register (www.fsa.gov.uk/register/) under reference 217742.
The guidance and/or advice contained within this web site is subject to the UK regulatory regime and is therefore primarily restricted to consumers based in the United Kingdom.
UK only