Annuity Request Form

The quote you have requested requires that you complete the following survey as completely and accurately as possible. Once submitted the information will be e-mailed to our office(s) and we will expedite your request. This information will be kept confidential and will be used for quote purposes only. We look forward to serving you.
  • Quote Information

  • Please give any additional comments you feel appropriate for this quotation.
  • This is a solicitation of insurance. By submitting this form, you are requesting an insurance agent (in WA: producer) to contact you by telephone.

Securities offered through Mutual of Omaha Investor Services, Inc., A Registered Broker/Dealer Member. FINRA/ SIPC. Richard McDaniel, Registered Representative. Advisory Services offered through Mutual of Omaha Investor Services, Inc., a SEC Registered Investment Advisory Firm. Richard McDaniel, Investment Advisor Representative. McDaniel Financial Services and Mutual of Omaha Investor Services, Inc., are not affiliated. The information provided is general in nature. It has been obtained from sources believed to be reliable, but no warranty is made as to its accuracy, timeliness or completeness. The information is not intended, and should not be construed as legal, tax or investment advice, or a legal opinion. Consult with your legal, tax or investment professional before taking any action based on this information. This is not an offer of solicitation in any jurisdiction where we are not authorized to do business.