AGIS Insurance Center

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Annuity
Insurance Company Preference (if any):
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Select one of the following annuity products
Single Premium Deferred	Deposit:
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Annual Deposit	AND / OR Monthly Deposit
OR
Single Premium Immediate
Single Premium Deposit	AND / OR Modal Benefit Desired

Benefit Mode:	Annual Semi-AnnualQuarterlyMonthly
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Life Only	Life and Years Certain
Year certain only/# of years: Installment Refund

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AGIS Insurance Center, Inc.
165 Bishops Way Suite 120
Brookfield, WI 53005
Phone: 262-641-9800
Email:AGIS.HOME@agisins.com

Hours of Operation

Monday - Friday 8:30am to 5:00 pm CST
Or by Appointment