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Get Athene 19740 2018

Please complete separate forms for any additional contracts being replaced. Owner Name Product Specs and Features Replaced Contract 2nd Replaced Contract (If applicable) Proposed Contract Athene Performance Elite 15 1. Name of Company Athene Annuity and Life Company 2. Type of Contract - Ex. Variable, Fixed, Life 3. Contract Number Fixed Indexed 4. Date of Issue 5. Initial Premium $ $ $ % Please see the Certificate of Disclosure Rate Insert for current Premium Bonus rate.

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