N.M. Admin. Code tit. 13, ch. 9, pt. 20, app C
Do Not Sign This Form Unless You Have Read and Understand It.
WHY ARE YOU BEING GIVEN THIS FORM?
You are buying a financial product: an annuity.
To recommend a product that effectively meets Your needs, objectives and situation, the agent, broker or insurer has the responsibility to learn about You, your financial situation, insurance needs and financial objectives.
If You sign this form, it means You know that you are buying an annuity that was not recommended.
Statement of Purchaser:
I understand that I am buying an annuity, but the agent, broker or insurer did not recommend that I buy it. If I buy it without a recommendation, I understand I may lose protections under the New Mexico Insurance Code.
__________________________________________
Consumer Signature
______________________
Date
__________________________________________
Insurance Producer Signature
______________________
Date
N.M. Admin. Code tit. 13, ch. 9, pt. 20, app C