Delaware Administrative Code
Title 18 - Insurance
1200 - Life Insurance and Annuities
1214 - Suitability In Annuity Transactions
Appendix B - Consumer Refusal to Provide Information

Universal Citation: 18 DE Admin Code B
Current through Register Vol. 28, No. 3, September 1, 2024

Do Not Sign Unless You Have Read and Understand the Information in this Form

Why are you being given this form?

You're buying a financial product - an annuity.

To recommend a product that effectively meets your needs, objectives and situation, the agent, broker, or company needs information about you, your financial situation, insurance needs and financial objectives.

If you sign this form, it means you have not given the agent, broker, or company some or all the information needed to decide if the annuity effectively meets your needs, objectives and situation. You may lose protections under the Insurance Code of [this state] if you sign this form or provide inaccurate information.

Statement of Purchaser:

I REFUSE to provide this information at this time.

I have chosen to provide LIMITED information at this time.

Customer Signature

Date

Disclaimer: These regulations may not be the most recent version. Delaware may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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