This checklist will help you prepare for your Annual Review. Please print and complete a copy of the checklist. It will help you to organize your financial information prior to your review with a New York Life Agent.

Date:

Name:

Residence Phone:

Business Phone:

---

Since our last annual review, I:

• Have changed my residence/business address and/or telephone

      My new address is:

      My new phone number is:

• Have bought a house
• Have had a new baby and

      His/Her name is:

      Date of Birth:

• Have changed my marital status
• Made a change in employment
• Started a new business
• Acquired/lost insurance coverage:
  
  
  • Medicinal
  • Disability
  • Life
• Wish to change the beneficiary on one or more policies
• Wish to review my policies

I would like to learn more about:

Personal Insurance Planning for:

• Life Insurance Needs
• College Funding
• Mortgage Funding with life insurance
• Funding Qualified Retirement Plans
• Estate Conservation
• Charitable Giving
• Gifts to Children/Grandchildren
• Other

Products Offered:

• Individual Life Insurance
• Fixed ^* and Immediate Annuities
• Disability Income Insurance ^**
• Health Insurance ^**
• Employee Health Benefit Plans ^**
• Long-Term Care Insurance

Business Insurance Planning for:

• Business Overhead Expense Insurance  ^**
• Buy-Sell Funding
• Deferred Compensation funding with life insurance
• Executive Bonus plans with life insurance
• Salary Continuation Plans ^**
• Funding for Qualified Plans
• Key Person Protection with life & disability income insurance^**
• Other

New York Life Insurance Company, 51 Madison Avenue, New York, NY 10010
New York Life Insurance and Annuity Corporation (A Delaware Corporation), 51 Madison Avenue, New York, NY 10010

* Issued by New York Life Insurance and Annuity Corporation (A Delaware Corporation), a wholly-owned subsidiary of New York Life Insurance Co.
** Products available through one or more carriers not affiliated with New York Life, dependent on carrier authorization and product availability in your state and locality.

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