Tax Balance Planning Fact Finder
Agent Name
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Last Name
SVP (recruiter)
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Tax Balance Planning Fact Finder
Client Information
Insured #1
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First Name
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Male / Female
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Age / DOB
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Class / Health Issues
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Insured #2
First Name
Last Name
Male / Female
Please Select
Male
Female
Age / DOB
State
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Class / Health Issues
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Tax Balance Planning Fact Finder
Insurance Parameters
Preferred Product(s)
*
VUL
WL
IUL
Assumed Returns: VUL (optional)
Assumed Returns: IUL (optional)
Annual Funding
*
Funding Years
*
Retirement Age
*
Cash Flow Years
*
Death Benefit (optional)
Please indicate any additional preferences (such as LTC rider, High Early Cash Value, Premium Deposit Account, Fixed vs Participating Index loans, uneven funding pattern, etc. – we may call to discuss)
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Tax Balance Planning Fact Finder
Please indicate details of any existing coverage to be replaced
Product Type
Death Benefit
Premium
Cash Value
Loan Balance
Other
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Tax Balance Planning Fact Finder
Additional Considerations
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