New Era Life Forms

The Fisher Agency

Danny Fisher, CLU, ChFC
President     1-800-822-1450

Financial Advisors Since 1975

13140 Coit Road, Suite 102  Dallas, TX 75240-5797

Home PageTop 10 PageForms 

FOR AGENT USE ONLY!

Form Description\Program

Microsoft Word 97 or 2000 

Adobe Acrobat 5.0 or better 

INSTRUCTIONSGet Free Word Viewer(3.8 M)Get Free Acrobat PDF Viewer(5.6M)
To Print Right-Click on Link > Print Target Print from Acrobat Window
To Download  Right-Click on Link > Save Target Right-Click > Save Target

New Era Life
Note: As of 6/01/2010, the Home Office address has changed.

Form Description\Program

Microsoft Word 97 or 2000 

Adobe Acrobat 5.0 or better 

Application Form - Secure Choice 3  Front & BackFront & Back  Fillable
Application Form - Secure Choice 5 Front & BackFront & Back  Fillable
Application Form - Accumulator 3Front & Back (Internal Exchange)Front & Back (Internal Exchange)
Application Form - Accumulator 5 Front & Back (Internal Exchange)Front & Back (Internal Exchange)
Current Rates (New Money and Internal Exchange)1 Page1 Page
Suitability Form (Required)1 Page1 Page Fillable
Replacement Form (Required)Front & BackFront & Back
Transfer Form - Non-Qualified & Qualified1 Page1 Page Fillable
Internal Exchange Form1 Page1 Page
Service Form - Distribution RequestFront & BackFront & Back Fillable
Service Form - Policy ServiceFront & BackFront & Back Fillable
Service Form - Change of Beneficiary (Secure Choice)1 Page1 Page
Service Form - Change of Beneficiary (Accumulator)1 Page1 Page
Service Form - Claimant StatementAll PagesAll Pages
Service Form - Affidavit of Trustee1 Page1 Page
Agent's Contracting FormsRequest By Email (PDF ->)All Pages

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