MoneyGuard® ClickQuotesm Request

Step #1: Please tell us about yourself

Name: Firm/Branch:
Phone:
E-mail:
Life & Health Licensed ?         Yes No

Do you have your LTC CE?       Yes No
(required in CA CO DE IL IN MD NC WA)

Sold LTC before?                    Yes No

Step #2: Think of a suitable client and suitability checklist.

Suitability checklist:

No obvious physical impairments (walker, quad cane, etc)

No mental impairments (memory loss, etc)

No planned or recent surgery

$75,000+ cash or liquid assets in bank or brokerage account
Under age 81 (76 for Flex)
Mr. Birth Date: Smoker? Yes No
Mrs./Ms. Birth Date: Smoker? Yes No

Step #3: Ask us to design a proposed plan.

Desired Monthly LTC Benefit: $
Client has $ available.
Source of Funds
 
Cash:
   
 
Old Cash value life insurance policies:
   
Other :
   
Special Instructions:
For Agent or Broker Use Only. Not To Be Used With The General Public.
Please email by clicking on “Send a Copy” button above Or fax to: (732) 741-8752
 

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