PREMIUM DEFERRED 2026

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The document is an application form for a Personal Choice Annuity offered by Sentinel Security Life Insurance Company. It includes sections for personal information, premium allocation, optional riders that provide additional benefits, and signatures from the annuitant and producer. The form outlines various features of the annuity, including guarantee periods, withdrawal options, and conditions for accessing funds in case of terminal illness or nursing home confinement.

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Click ‘Get Form’ to open the PREMIUM DEFERRED application in the editor.
Begin by filling in your personal information. Enter your last name, first name, and street address in the designated fields. Ensure accuracy as this information is crucial for processing.
Next, provide details about the annuitant including their date of birth, Social Security Number (SSN), and contact information. This section is vital for identification purposes.
Select your premium allocation by choosing either option 1 or 2. Make sure that the total equals 100% as required.
Review the optional riders section carefully. Check any applicable boxes next to the riders you wish to select or decline all by marking 'NONE'.
Complete the signature section at the end of the form. Ensure all signatures are provided where necessary to validate your application.

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