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Sample Mortgage Application Packet - TAG U Senior

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Americo Financial Life<br />

and Annuity Insurance Company<br />

Home Office: Dallas, Texas • Administrative Office: P.O. Box 410288, Kansas City, MO 64141-0288<br />

Use this receipt when<br />

no premium payment<br />

is received at the<br />

time of application.<br />

It must be signed and<br />

dated and submitted<br />

to the Home Office<br />

with the application.<br />

Use this receipt when<br />

a premium payment is<br />

received at the time of<br />

application. Tear off<br />

and leave with client.<br />

04-130-1(12/06) © Americo 6 of 7 For Agent Use Only. Not For Public Use.<br />

State Variations Apply

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