Need A Quote - Article - Chris D. Callen, Insurance Agent

To get a customized quotation or analysis, please download the following PDF form Health & LIfestyle questionairre, complete it and fax back to us at 877-630-9889 or email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it . Remember, the more information you give us the better we can help and the more cost effective our proposals will be.

On receipt of your completed form we will contact you by telephone to set a time to collect any additional information that might be required, and also to set a tele-conference date and time to go over your request.

Our Focus Strategy Approach allows us to design a specific personal or business insurance portfolio for you. Just check off or fill in the items below to get started. It's that simple! We'll then contact you by to complete your insurance analysis - a face-to-face meeting is never required. Complete The Following Form:

Individual Health Insurance

Term Life Insurance

Amount $

Term Length Desired:

10 Years
15 Years
20 Years
30 Years

Guaranteed Universal Life To Death (like a Term To Death)

Amount $

Whole Life

Amount $

Term Length Desired:

10 Years
To Age 65

Business Continuation Buy-Sell Life

Amount $

Term Length Desired:

10 Years
15 Years
20 Years
30 Years

Key Person Life (will need to collect health and lifestyle information on the key person)

Amount $

Term Length Desired:

10 Years
15 Years
20 Years
30 Years

Loan Protection Planning

Choose One

Life Only
Disability Only
Disability and Life

Choose One :: For Disability & Life - We will need a copy or draft of loan agreement

Personal Disability Income Insurance

Personal Disability Income Insurance :: Will need a copy of the most recent personal tax return and current W2 if available.

Overhead Disability Income Insurance

Overhead Disability Income Insurance :: Will need a copy of the most recent personal tax return and current W2 if available.

Key Person Disability

Key Person Disability :: Will need to collect health and lifestyle information on the key person.

Business continuation Buy-Sell Disability Income Insurance

Amount $

Elimination Period

Long-Term Care Insurance

Choose One

Self Only
Self and Spouse

Choose One :: Self Only (will need to collect health and lifestyle information) Self and Spouse (will need to collect health and lifestyle information on both of you)

Fixed Annuity with 8% guaranteed minimum withdrawal benefit

Fixed Annuity with 8% guaranteed minimum withdrawal benefit (GWMB) :: (GWMB)

Initial Amount

What Age Do You Intend To Start Drawing Out Funds?

Estate Preservation

Estate Preservation :: Second to die life insurance - Will need to collect health and lifestyle information on both of you

Tax Free Exchange

Tax Free Exchange :: IRS 1035 - Existing life insurance or variable annuity to fixed annuity with 8% guaranteed minimum withdrawal benefit -GWMB

Other

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