IRA [] Individual Retirement Annuity (IRA) [] Contribution for calendar year _________ to a [] Regular IRA or [] Roth IRA [] Rollover* from a [] Regular IRA or [] Roth IRA [] Transfer* from a [] Regular IRA or [] Roth IRA The taxable year for which I...Individual Deferred Variable Annuity Application • April 30th, 2003 • Safeco Separate Account C
Contract Type FiledApril 30th, 2003 Company
Telephone (_____)________________________ Soc. Sec. #_____________________ Date of Birth_________________ Mo. Day Yr. IF NO ANNUITANT IS SPECIFIED, THE OWNER WILL BE THE ANNUITANT. -------------------------- -----------------------------...Individual Deferred Variable Annuity Application • October 6th, 2000 • Safeco Separate Account C
Contract Type FiledOctober 6th, 2000 Company