Attachment III: Life Agent Disclosure
Requirement (AB2107, Chapter 547) (Continued)
Legislative Counsel's Digest (Continued)
(Sample from Insurer)
TITLE:____________________________________________
TO:______________________________________________
Prospective California Client (please print)
FROM:___________________________________________
Agent (please print)
Pursuant to California Insurance regulation, I am required to advise you of the following:
In the event I recommend that you sell or liquidate any stocks, bonds, IRA, certificate of deposit, mutual fund annuity, or other assets to fund the purchase of an annuity from an insurance company, you may be subject to some or all of the following:
- Tax consequences;
- Early withdrawal penalties;
- Or, other costs or penalties.
You may wish to consult an independent legal or financial adviser before selling or liquidating any assets and prior to purchasing an annuity. I acknowledge receipt of this disclosure and understand its contents.
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Signature of Prospective California Client |
Date |
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Signature of Agent |
Date |
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