Unallocated Registered Variable Contract Application, Acceptance, & New Business AgreementGroup Annuity Contract Application • March 7th, 2008
I/We have appropriately acted on behalf of my/our client(s) by reviewing all the points in this disclosure. I/We believe that the information provided is true and accurate to the best of my/our knowledge. (If more than one Registered Representative, each must sign, date, and legibly print name.)