New Era Life of the Midwest Forms

The Fisher Agency

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

Financial Advisors Since 1975

Phone Numbers and Map

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

Home PageTop 10 PageForms 

FOR AGENT USE ONLY!

Form Description\Program

Adobe Acrobat 5.0 or better 

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New Era Life of the Midwest (Select this Company on the form header) [ For company website -> www.NewEraLife.com ]

Form Description\Program

Adobe Acrobat 5.0 or better 

NEW-Effective Dec 2022 Application/Disclosure Form - Top Choice 3 & 5  (1% Min Guar)All Pages  Fillable
NEW-Effective Dec 2022 Internal Exchange - Top Exchange 3 & 5  (1% Min Guar)Front & Back (Internal Exchanges Only)
Application/Disclosure Form - Secure Choice 3 & 5 (2% Min Guar)All Pages  Fillable
Internal Exchange - Exchange Choice 3 & 5 (2% Min Guar)Front & Back (Internal Exchanges Only)
Suitability Form (Required for New Applications and Internal Exchanges) (Updated for Use as of Sep 1, 2021)3 Pages
Replacement Form (Required for New Applications and Internal Exchanges)Front & Back
Agent Disclosure  (Required as of Sep 1 ,2021)1 Page
W9 (Required)1 Page
Transfer Form - Non-Qualified & Qualified1 Page Fillable
Service Form - Distribution RequestFront & Back Fillable
Service Form - Policy ServiceFront & Back
Service Form - Change of Beneficiary (Secure Choice, Exchange Choice, Top Choice or Top Exchange)1 Page
Service Form - Change of Annuitant (Secure Choice, Exchange Choice, Top Choice or Top Exchange)1 Page
Agent Contracting KitAll Pages
NEW-Effective 1/05/2023- Product Specific Training for Current Texas AgentsAll Pages
Agent Beneficiary Form1 Page

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