TM American Equity Investment Supply Request Form

TM American Equity Investment Life Insurance Company?

Supply Request Form

TM

E-mail this form to AE

Name ______________________________________ Firm _______________________________________________

Address ________________________________________________________ Date ___________________________

City _________________________________________________ State ________ Zip ________________________

Agent Number _______________ Telephone Number ________________________________________________

INSTRUCTIONS: 1. Complete above section. For overnight delivery,

please list street address, P.O. Box is not acceptable.

2. Indicate quantities for each item ordered.

3. Please submit this form to: Phone: 888-647-1371 Fax: 515-221-9895 Email: supply@american-

Please indicate state(s) you request materials for: __________________________________________________

Annuity New Business Forms

Bonus Gold

#

Description

Application Packet

Suitability Guidelines

Suitability Form Instructions

Form Number

01F4106 01F4106-INS

#

Description

Bonus Gold Sales Brochure

Bonus Gold Disclosure

Destinations

Form Number 01SB1107 01D1107

AssetShield Series

#

Description

Form Number

AssetShield Series Sales Brochure (Not for use in CA or ID)

01SB1165

AssetShield 5 Sales Brochure (Not for use in CA and ID)

01SB1165-5-EN

AssetShield 5 Sales Brochure (For use in CA and ID only)

01SB1165-5

AssetShield 5 Disclosure

01D1165-5

AssetShield 7 Sales Brochure (Not for use in CA and ID)

01SB1165-7-EN

AssetShield 7 Sales Brochure (For use in CA and ID only)

01SB1165-7

AssetShield 7 Disclosure

01D1165-7

AssetShield 10 Sales Brochure (Not for use in CA and ID)

01SB1165-10-EN

AssetShield 10 Sales Brochure (For use in CA and ID only)

AssetShield 10 Disclosure (For use in CA and ID only)

01SB1165-10 01SB1165-9-CA

01D1165-10 01D1165-9-CA

Preservation and Accumulation AssetShield Flyer

01FFIAPA-1165

AssetShield Index Option Brochure

01B1165-IO

Performance Rate Rider Flyer

01F1165-PRR

Agent Use Only

AssetShield Series Excess Return 01F1165-10XR

Performance Flyer

01F1165-CA-9XR

#

Description

Form Number

Destinations Sales Brochure 01SB1168-10

(For CA and ID use only)

01SB1168-9-CA

Destinations Disclosure

01D1168-10

(For use in CA and ID only) 01D1168-9-CA

Agent Use Only - (For use in CA and ID only)

Destinations Annuity Promotional Flyer (For use in CA and ID only)

01F1168

EstateShield

#

Description

Form Number

EstateShield 10 Sales Brochure 01SB1167-10

EstateShield 10 Disclosure 01D1167-10

EstateShield 10 Building Lifetime Income and Legacy Benefits Flyer

01F1167-BLI

EstateShield 10 Enhanced Death Benefit Flyer

01F1167-EDB

EstateShield 10 Increasing Lifetime Income Flyer

01F1167-ILI

Agent Use Only EstateShield 10 BAV Premium Bonus Flyer

Fixed Annuities

01F1167-PB

#

Description

Form Number

Guarantee Sales Brochure 01SB1149

Guarantee Disclosure

01D1149

GuaranteeShield Series Sales Brochure

01SB1169

GuaranteeShield 3 Disclosure 01D1169-3

GuaranteeShield 5 Disclosure 01D1169-5

GuaranteeShield Flyer

01F1169

01SR4017 09.01.21

**=Print on Demand Piece

Page 1 of 2

?2021 American Equity. All Rights Reserved.

Immediate Annuities (See Approval Chart form #01F1025) Retirement Information Materials

#

Description

Form Number

SPIA-1 Immediate Annuity Disclosure

01D1023 (CA, CT, FL, MT only)

SPIA Immediate Annuity Disclosure 01D1159

IncomeShield Series

#

Description

IncomeShield 7 Sales Brochure

IncomeShield 7 Disclosure

IncomeShield 10 Sales Brochure (9 for CA)

IncomeShield 10 Disclosure (9 for CA)

IncomeShield with LIBR & Wellbeing Rider Flyer

Agent Use Only

IncomeShield Series Flyer**

IncomeShield 10 Flyer**

Form Number 01SB1164-7 01D1164-7 01SB1164-10 01SB1164-9-CA 01D1164-10 01D1164-9-CA

01F1164-WBFAQ

01F1164 01F1164-10 01F1164-9-CA

Retirement Gold

#

Description

Retirement Gold Sales Brochure

Retirement Gold Disclosure

Form Number

01SB1119 01SB1132-FL

01D1119 01D1132-FL

Company Materials

#

Description

Form Number

Statutory Financial Facts

01FSFF

Standard Independent Comparative

The American Equity Advantage Brochure

01BAEA

American Equity Company Brochure 01BAECO

Values Calculation**

01F1057

American Equity Market Value Adjustment Flyer**

01F4963

5 Benefits of an American Equity Annuity

01F5BB

Industry Accolade Sheet**

01F4379

Split Annuities Combined Benefits Flyer

01FSACB

Index Strategy Materials

#

Description

Preparing for Retirement Transitions

How a Fixed Index Annuity Can Work for You

Lifetime Income Solutions Infographic**

Guide to Fixed Index Annuity Basics**

Competitive and Consistent Flyer

Help Protect Your Top Assets**

Medicare Guide

What's Your Risk Tolerance?

Rule of 72

Sequence of Return Risk Flyer

Risk Tolerance Wheel

Creating a Retirement Income Blueprint Brochure

Agent Use Only

Conversation Cues**

Retirement Milestones for Singles Infographic

Form Number 01BACC

01BBBV

01F8150-0001

01FANBSC 01FCC 01FHPTA 01FMEDG 01FRISK 01FRULE72 01FSORR 01WLC4790 01B1164-RIB

01FBBV-CC 01FRMFS

Rider Materials

#

Description

Frequently Asked Questions

Wellbeing Benefit Rider FAQ Flyer**

Waiver of Surrender Charge Riders Brochure

Rate Integrity Rider Flyer

Agent Use Only Indexing Income Calculation**

Form Number 01BLIBR-FAQ 01F1157-CA 01FWBFAQ

01F1001 01FRIR

01F1157-0001

Tax-Related Materials

#

Description

Partial Roth Conversions

Advantages of Tax-Deferred Annuity

Form Number 01FPRC

01FATDA

For any questions or to request other forms, please call Marketing at 888-647-1371.

#

Description

NeXt Allocation Brochure

Dividend Aristocrats Brochure

Preservation & Accumulation

Form Number 01B1165-WN 01BDIV 01FFIAPA

01SR4017 09.01.21

**=Print on Demand Piece

Page 2 of 2

?2021 American Equity. All Rights Reserved.

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