Inforce Illustrations Request Form
Request Form
* Required Field
Requestor Information
Requestor Name:
*
Requestor Email:
*
Agency Name:
Agency Code:
Phone Number:
Policy Number:
*
Insured #1 Name:
*
Insured #2 Name:
Select Illustration Type
Current PPP
No Further Premiums
Solve Level PPP to Endow at Maturity
Solve Level PPP to Zero Cash Value at Maturity
Compute level premium needed to keep coverage in force
To Age:
Cash value at future target age:
$
Solve for number of years to pay level premiums to reach
specified target
Premium Amount:
$
Cash value target:
$
Target Age:
(maturity if blank)
Decrease face amount
Solve for Decrease Face Amount at Specified Premium
Premium Amount
Year of
Decrease
Pay Premium to Age
Maintain Coverage to Age
Request 1:
$
Request 2:
$
Solve for Premium at Decreased Face Amount
Proposed Face Amount
Year of Decrease
Pay Premium to Age
Maintain Coverage to Age
Request 1:
$
Request 2:
$
Other Illustration Scenario
Loan/Surrenders
Policy
Start
Year
Policy
End
Year
Amount
Initiate loan(s)
Repay loan(s)
Initiate partial surrender(s)
Partial surrender to repay loan
Future Premium
Use Current Premium Amount
Solve For Premium
Pay to Age:
Cash Value Target:
Target Age:
Specify Premium Amount
Premium Amount:
Pay to Age:
If loan exists, pay loan interest in cash.
Yes
No
DESTINATION
Where Should Illustrations Be Sent
Email (Preferred method)
Fax Number and Recipient Name or Mailing address
Other
Comments and/or Special Instructions