SAFE HARBOR FINANCIAL

TOTAL REWARDS

Marketing Expense

Reimbursement Program

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First & Last Name

E-mail address

Street Address (address you want your check sent)

City

State

Zip Code

Phone number

I am an insurance/financial professional

800.422.0557

FOR FINANCIAL PROFESSIONALS ONLY - NOT INTENDED FOR CONSUMERS

monthly .50% reimbursement check based on previous month's* paid fixed index annuity premium
sent by the 15th of each month

*Available only to agents contracted direct with Safe Harbor at street level. Issued by official company check and subject to 1099 tax reporting. Certain carrier exclusions apply. Final interpretation of rules and reimbursement rewards subject to the sole discretion of Safe Harbor Financial Inc.