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Date of birth

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Personal Life insurance

Type: Permanent / Term
Premium
Death Benefit
Surrender Value
Desired amounts: (Debt, income x10, final expenses, kids college, legacy)
Purpose: Personal, Debt, income planning, estate taxes, retirement, cashflow, bank
Any other policies? Premium / benefit amount / cash value
Do you have the new life insurance with critical and/or chronic illness, and Long term care?
Do you have group life insurance? How much and what amount / type is it?
When did you last have a review?

Existing Life insurance

Do you have any existing individual life insurance policies and/or annuity contracts in force?
If yes, the total amount of existing insurance in force is
1. Company / Policy # / Type (permanent/term) / Amount / Year issued / Replace?
2. Company / Policy # / Type (permanent/term) / Amount / Year issued / Replace?
3. Company / Policy # / Type (permanent/term) / Amount / Year issued / Replace?
4. Company / Policy # / Type (permanent/term) / Amount / Year issued / Replace?
5. Company / Policy # / Type (permanent/term) / Amount / Year issued / Replace?
Do you have any pending individual life insurance policies and/or annuity contracts?
Is the policy applied for intended to replace, in whole or in part, any existing life insurance or annuity?

10 Critical Reasons to plan with Life insurance

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