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Ce Company and Jackson National Life Distributors, Inc. Member NASD. Home Office: Lansing, Michigan www.jnl.com Please type or print all requested information. Broker/Dealer Name Producer Information Non-Bank/Bank Sales: For relationship management and distribution channel purposes, please tell us how you market insurance products ( those that apply): In a bank/credit union lobby Through non-bank relationships Through a working relationship with a bank/credit union Full Name (as it appea.

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