Freedom Income - Quote

Annuity Information

Issue State*

Please Select Alabama Alaska Arizona Arkansas California Colorado Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Payout Option*

Please Select Certain Only Single Life Only Single Life with Period Certain Single Life with Installment Refund Single Life with Cash Refund Joint Life Only Joint Life with Period Certain Joint Life with Installment Refund Joint Life with Cash Refund   Learn about Payout Options

Death Benefit Option*

Yes No

Electing the Optional Death Benefit will reduce the Payment Amount or increase the Purchase Payment.

Annuitant* Gender Female   Male   Date of Birth   Age  We will issue contracts only for an annuitant (or joint annuitant) age 90 or younger.

Guaranteed Period*	Number of Years
	Number of Payments

Payment Frequency*	Monthly Quarterly Semi-Annually Annually

Payment Start Date*	Must be more than 13 months in the future
Contract Type*	Non-Qualified Qualified - Traditional IRA Qualified - Roth IRA   Learn about Contract Types

Solve Using*	Purchase Payment	$ $10,000 minimum
	Payment Amount	$ $100 minimum

Cost Basis*	Enter Amount	$
	Unknown

Annual Payment Increase

%

0.10% - 6.50%

*Denotes a required field

We respect the privacy of our customer's personal information and don't sell it to others. The Application Package contains Symetra Financial's Consumer Privacy Statement, which should be provided to the consumer. Annuity is issued by Symetra Life Insurance Company, 777 108th Ave NE, Suite 1200, Bellevue, WA 98004-5135. Not available in all U.S. States or any U.S. territories. Freedom Income Contract form number is LIA-76 2/08 in most states.

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For assistance, please contact Symetra Financial| Email Us | 1-800-706-0700 7 a.m. to 4:30 p.m. PT

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