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TR-F03 · 在线填写 · 存为 PDFTR-F03 · Fill in online · Save as PDF

年金客户信息表

Annuity Client Profile

直接在这一页填，填完点「保存为 PDF」，把 PDF 交给你的代理人。 你填的内容只留在这台设备的浏览器里，网站不接收、不保存；关掉页面就没了，所以请填完一次存好。 填了社安号或银行账号的 PDF 请当面交给代理人或加密传送，不要直接发微信、短信或普通邮件。

Fill this page in, then press Save as PDF and give the PDF to your agent. What you type stays in this device's browser; the site neither receives nor stores it, and it is gone when you close the page, so finish and save in one go. If the PDF holds an SSN or bank details, hand it to your agent in person or send it encrypted, never by WeChat, text or plain email.

空白 PDF（打印手写）Blank PDF (to print)

点「保存为 PDF」会打开打印窗口：电脑把「目标打印机」选成「另存为 PDF」； iPhone / iPad 点右上角分享图标 → 存储到「文件」；安卓把打印机选成「保存为 PDF」。Save as PDF opens the print dialog. On a computer, set the destination to “Save as PDF”. On iPhone / iPad, tap the share icon at the top, then Save to Files. On Android, choose “Save as PDF” as the printer.

年金客户信息表Annuity Client ProfileAnnuity Client Profile
TEAM RISETR-F03
请注意Please note

本表只用于年金面谈时整理信息，内容对应保险公司的适当性问卷（Suitability），不是保险公司的申请书，正式投保以保险公司当期的申请表 / 电子投保（eApp）为准。填了社安号、银行账号的 PDF 是敏感文件：请当面交给代理人或加密传送，不要通过微信、短信或普通邮件发送；递交后由代理人删除。This sheet organises information for an annuity meeting and mirrors the carrier's suitability questionnaire. It is not the carrier's application — the carrier's current form or eApp governs. A PDF with an SSN or bank details in it is sensitive: hand it to your agent in person or send it encrypted, never by WeChat, text or plain email. Your agent deletes it after submission.

本次申请This application

年金类型Annuity type

持有人 / 年金领取人Owner / annuitant

性别Sex
婚姻状况Marital status
身份Status

共同持有人（如有）Joint owner (if any)

收入、开销与税率Income, expenses and tax bracket

这一节和下一节都写全家合计，不含这次要买年金的钱。收入含工资、社安金、pension、投资和租金；开销含住房、交通、保险、吃饭、医疗和税。This section and the next are household totals, excluding the money for this annuity. Income: salary, Social Security, pension, investments, rent. Expenses: housing, transport, insurance, food, healthcare, taxes.

联邦税档Federal tax bracket
工作状态Employment status

流动资产与净资产Liquid assets and net worth

流动资产只算随时能取、没有解约费的钱：支票、储蓄、货币基金、股票、债券、基金、没有解约费的年金。只写数字即可，例如 120000；合计会自动算。Liquid means money you can take out any time without a surrender charge: checking, savings, money market, stocks, bonds, funds, annuities with no surrender charge. Numbers only, e.g. 120000; the total fills itself in.

负债与期限Liabilities and remaining term

风险承受与时间Risk tolerance and time horizon

这笔钱的风险承受度Risk tolerance for this money
第一个保单年度内，除了 RMD 或终身收入领取外，会不会需要从年金里取钱？Will you need withdrawals in year one, other than RMDs or lifetime-income payments?
退保费期间内，会不会有哪一年取超过账户价值的 10%？In any year of the surrender period, will you take more than 10% of the value?
会不会在退保费期满之前整笔解约？Might you surrender the whole annuity before the surrender period ends?
过去 60 个月内是否做过年金交换（1035）？Any annuity exchange (1035) in the last 60 months?
这份年金要解决什么（可多选）What should this annuity do (tick any)

资金来源Source of funds

钱从哪里转来。直接从银行付款的话，转出机构这几栏不用填，只填下面的「付款银行信息」。Where the premium comes from. If it is paid straight from a bank, skip the transfer fields and fill in the bank section below only.

这笔钱原来放在哪里（可多选）Where the money is now (tick any)
账户税务属性（可多选）Tax status of the money (tick any)
是否替换现有年金或保单？Replacing an existing annuity or policy?

如果钱来自现有寿险或年金，保险公司需要下面这张表，并附最近一期报表。If the money comes from an existing policy or annuity, the carrier needs this grid plus the latest statement.

公司 · 产品Company · product类型Fixed / Indexed / Variable持有年数Years owned现金价值Value退保费Surrender chargeMVA（±）MVA (±)保证利率 / 上限Guaranteed rate / cap附约与费用Riders and fees

付款银行信息Bank details for payment

对着支票底部那一行数字填：路由号码 9 位，不能以 5 开头；账号在路由号码右边。Copy them from the line along the bottom of a cheque: the routing number is nine digits and cannot begin with 5; the account number sits to its right.

账户类型Account type

受益人Beneficiaries

第一顺位（Primary）全部过世后才轮到第二顺位（Contingent）。同一顺位的百分比合计必须是 100%。受益人若是信托，写信托全名、签立日期、受托人与税号。Contingent beneficiaries receive only if no primary beneficiary survives. Percentages within each class must total 100%. For a trust, give its full name, date, trustees and tax ID.

顺位Class英文全名Full legal name与持有人关系Relationship出生日期DOBSSN（可选）SSN (optional)比例%

备注Notes

需要准备的证件Documents to have ready

需要准备的证件（勾选已备好的）Documents to have ready (tick what you have)

Team Rise · 面谈信息收集用，不是保险申请书 · TR-F03Team Rise · For fact-finding only — not an insurance application · TR-F03

空白 PDF（打印手写）Blank PDF (to print)

本表是 Team Rise 团队自制的面谈信息表，不是保险公司或计划服务商的申请书，填写不代表投保、承保或任何承诺。 正式申请以保险公司当期的申请表 / 电子投保与您的签名为准；税务与退休计划问题请咨询您的会计师或税务律师。

This is Team Rise's own fact-finding sheet, not an application to any carrier or plan provider; completing it does not apply for, bind or promise any coverage. The carrier's current application or eApp and your signature are what count; please take tax and retirement-plan questions to your CPA or tax attorney.