FOR AGENT USE ONLY!
| Form Description\Program |
|
|
|---|---|---|
| INSTRUCTIONS | Get 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 |
Microsoft Word 97 or 2000 
Adobe Acrobat 5.0 or better New Era Life of the Midwest (Select this Company on the form header)
| Form Description\Program | Microsoft Word 97 or 2000 | Adobe Acrobat 5.0 or better |
|---|---|---|
| Application Form - Secure Choice 3 | Front & Back | Front & Back Fillable |
| Application Form - Secure Choice 5 | Front & Back | Front & Back Fillable |
| Application Form - Accumulator 3 | Internal Exchanges Only | Internal Exchanges Only |
| Application Form - Accumulator 5 | Internal Exchanges Only | Internal Exchanges Only |
| Suitability Form (Required) | 1 Page | 1 Page Fillable |
| Replacement Form (Required) | Front & Back | Front & Back |
| Transfer Form - Non-Qualified & Qualified | 1 Page | 1 Page Fillable |
| Service Form - Distribution Request | Front & Back | Front & Back Fillable |
| Service Form - Policy Service | Front & Back | Front & Back |
| Service Form - Change of Beneficiary (Secure Choice) | 1 Page | 1 Page |
| Service Form - Change of Beneficiary (Accumulator) | 1 Page | 1 Page |
| Agent's Contracting Forms (for New Era agents) | Request By Email (PDF ->) | All Pages |
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