Texas Department of Insurance

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Life, Accident and Health Annuity Checklists

This is one of several pages linking to a central repository of forms used by TDI customers. Use the search or Forms by Type links on the Forms Home Page or scan through our form listings.

 

Annuity Checklists
TDI Form NumberDescriptionFile FormatLanguage
LHL315 Life/Health Annuity Applications
 PDFEnglish
LHL316 Life/Health Annuity Loan Provisions
 PDFEnglish
LHL317 Life/Health Annuities Used to Fund Structured Settlement Options
 PDFEnglish
LHL319 Life/Health Group Annuities Used as Funding Plans, Guaranteed Investment Contracts (GICs), and Synthetic GICs
 PDFEnglish
LHL320 Life/Health Guaranteed Living Benefit Endorsements/Provisions
 PDFEnglish
LHL321 Life/Health Individual and Group Deferred Annuities
 PDFEnglish
LHL323 Life/Health Single Premium Immediate Annuities
 PDFEnglish
LHL324 Life/Health Roth IRA Endorsements/Provisions
 PDFEnglish
LHL325 Life/Health SIMPLE IRA Endorsements/Provisions
 PDFEnglish
LHL326 Life/Health Guaranteed Minimum Death Benefit
 PDFEnglish
LHL327 Life/Health Variable Annuity Contracts
 PDFEnglish
LHL328 Life/Health Waiver of Surrender Charge Provisions/Riders on Disability/Confinement/Terminal Illness
 PDFEnglish
LHL349 Life/Health Individual Modified Guaranteed Investment Contracts Market Value Adjustment Provisions
 PDFEnglish
LHL368 Actuarial Certification of Compliance with Chapter 1107, Texas Insurance Code, for Equity Indexed Annuities
Actuarial Certification		 PDFEnglish
LHL369 Initial Actuarial Certification of Compliance with Chapter 1107, Texas Insurance Code, for Equity Indexed Annuities
Initial Actuarial Certification		 PDFEnglish
LHL653 Annuity Disclosure Checklist
 PDFEnglish

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