Mr. Maturing CD - Lincoln MoneyGuard� II (2019)

Asset identifier

Your plan to fund long-term care expenses

Date
Company
Address 1
Address 2
Phone number
Email address
As part of the ongoing financial process，____and I have reviewed and discussed the risks around a life-changing event，such as an extended need for care.The estimated current cost of long-termcare in your area is the following：*
• At home care=
• Assisted living=
• Private nursing home=
*Source for above costs=

You have informed me that they would like to self-insure against an extended healthcare need using the following assets:

Account name Account type Account value Account number

We will continue to review your plans to self-insure for long-term care expenses and how changes in your life may impact your future financial plans.

Client name:
Client name: print/sign
Client name:
Client name: print/sign
Advisor name:
Advisor name: print/sign