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LFD Financial Worksheet

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					                                      FINANCIAL UNDERWRITING WORKSHEET
                                                    The Lincoln National Life Insurance Company
                                                    Lincoln Life & Annuity Company of New York
                              For use on cases with an insured age 70 and older with face amounts exceeding $5,000,000.
                                           Underwriters may require tax returns for cases above $25,000,000


                              Insured:                                                      Case Number:
                                 *Age:                                                      *Product Type:    Single Life
                       Second Insured:                                                                        Use Drop-down Box
                                 *Age:                                                                        * = required field


Section 1 - Determining Net Worth

Assets (other than real estate) :
Cash                                                                                 $0
US Govt & Marketable Securities                                                      $0
Accounts, Loans & Notes Receivable                                                   $0
Personal Property                                                                    $0
Other Assets                                                                         $0

Real Estate Assets (street number, city, state required:)
Address Property 1                                                                   $0
Address Property 2                                                                   $0
Address Property 3                                                                   $0
Address Property 4                                                                   $0

Total Assets                                                                         $0

Liabilities:
Accounts & Notes Payable                                                             $0
Real Estate Mortgages Payable                                                        $0
Other Debts (car, credit cards, etc.)                                                $0

Total Liabilities                                                                    $0

Net Worth                                                                           $0


Section 2 - Identifying Sources of Income

Previous Year Income:
Base Salary                                                                          $0
Bonus and Commissions                                                                $0
Dividends and Interest Income                                                        $0
Real Estate Income                                                                   $0
Other Income                                                                         $0
(Please identify other income sources in Explanatory Notes #5)
Total Previous Year Income                                                           $0

Current Year Income:
Base Salary                                                                          $0
Bonus and Commissions                                                                $0
Dividends and Interest Income                                                        $0
Real Estate Income                                                                   $0
Other Income                                                                         $0
(Please identify other income sources in Explanatory Notes #5)
Total Current Year Income                                                            $0

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Section 3 - Explanatory Notes

1) Please explain the client's need for life insurance coverage and how the coverage amount was determined:




2) If annual premium is greater than 40% of Total Current Year's income (or 75% of Total Current Year's income if
Net Worth is greater than $10,000,000), please provide complete details and rationale for using a higher percentage
of current income to fund the life insurance premiums:




3) If it is recommended to the client that more than 5% of Net Worth is to be liquidated to pay premiums, please
provide reasons and details on liquidation plans:




4) If premium finance is being used, please explain client's exit strategy for repaying the loan. (Premium financing
certifications are required.)




5) Additional information or comments regarding the sale to aid in Underwriting evaluation:




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Section 4 - Signatures:
For cases $5,000,001 up to $10,000,000, Lincoln requires the client's signature only.
For cases $10,000,001 and over, Lincoln requires the client's signature AND either the client's Accountant, CPA
or Attorney signature to attest to the worksheet figures being complete and accurate.

The information shown on this form is complete and accurate to the best of my knowledge and belief.
Client
Signature:                                                                 Date:
Printed Name:

Accountant
Signature:                                                                                  Date:
Printed Name:
Address:                                                                                    Telephone:
Attorney
Signature:                                                                                  Date:
Printed Name:
Address:                                                                                    Telephone:
                              Underwriters may require tax returns for cases above $25,000,000.




Estimated Life Expectancy and Life Insurance Need Calculator


Years to Life Expectancy:                                                           82.4

Adjusted Life Expectancy for                                                                *Capped at 75% of Years to Life Expectancy up to 25 years.
Accumulation                                                                        25.0          No accumulation if client is older than age 80.


Value of Estate                                                                        $0
(assuming 6% annual growth of net
worth up to Life Expectancy for
Accumulation)

Estimated Life Insurance Need                                                          $0
(55% of Value of Estate)




IMPORTANT DISCLOSURES: The Financial Underwriting Worksheet is a tool for agents intended to assist with the
Underwriting process. All applications must go through standard underwriting review. This form is used in
conjunction with the standard underwriting process and does not guarantee issuance.

The Estimated Life Expectancy and Life Insurance Need calculator uses values from the unisex table specified by
US Treasury Department for Required Minimum Distributions from qualified retirement accounts. The US Treasury
Department table provides a basis for various financial calculations, but it does not predict any individual's actual
life expectancy.

Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates.




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