Name: XXXX XXXXXXXX
Address: XXXXX XXXXXXXXXX XXXX
Work Phone: XXX-XXX-XXXX
E-mail Address: xxxxxx@earthlink.net
Gender: XXXXXXXX
Birth date: 12/14/48
City: Farmington
State: New Mexico
Zip: XXXXX
Home Phone: XXX-XXX-XXXX
Best Time To Call: 8-20 a.m.
Amount of insurance wanted: $1,000,000 – $2,000,000
Type of insurance wanted: Whole Life
Primary purpose(s): Income to family after death
What term would you like: 99
Amount of Insurance now in force: $750,000.00
Premium you are paying per year: $7500.00
When is the last time you applied: 5+ years ago
To which companies: AXA Advisors
What Was The Outcome: Accepted
Do you use Tobacco: No
What type of tobacco products: N/A
Height: 5′ 7″
Weight: 178
Health Problems: None
Medications: None
Names/doses: N/A
Family member – Heart Disease/Cancer: None
Describe: N/A
AutoInsurance-Leads.com
567 San Nicolas Dr., Ste. 180
Newport Beach, CA 92660
Tel: 1 (800)-278-4195
Fax: 1 (949) 640-8307
