Dallas & Fort Worth Texas Individual Retirement Accounts   Jorge Garcia: your Dallas & Fort Worth Life Insurance Broker       Individual Retirement Accounts: IRA's, Roth IRA's, 401k Rollovers, TSA's, 403b Accounts   Retirement Annuities, Fixed Index Annuities, Tax Sheltered Annuities, Tax Shelters, Structured Settlements       Individual Retirement Account Information Request Form First Name Last Name Email Address Day Phone Evening Phone Mailing Address City, State & Zip Date of Birth Best Time To Call morning noon early afternoon late afternoon evening Do you have an existing IRA? yes no Is there, or will there be a joint account holder? yes: spouse yes: non-spouse no Primary goal for your account? Growth Retirement Income Asset or Wealth Protection Give to Charity Other Source of funds? Current Income Bank CD Savings 401k Rollover Existing IRA Qualified Account Non-Qualified Account 1035 Exchange Other Comments or concerns       Insurance Agents: Join the Your Insurance Advisor Network       Jorge Garcia: your Dallas & Fort Worth Life and Health Insurance Broker | www.GarciaAgency.com   Jorge Garcia Insurance Agency is a life and health insurance marketing firm serving North Texas (Dallas, Garland, Mesquite, Richardson, Irving, Denton & Fort Worth)           Copyright © 2005-2009 Jorge Garcia Insurance Agency & GarciaAgency.com. All rights reserved. Derechos reservados.