Life Insurance Needs Assessment

Life Insurance Needs Assessment

Please fill out this form to help us understand your insurance needs and provide personalized recommendations.
How much Life Insurance do you need?
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Expense: Income Replacement

Determining Formula: 7-10 Times your annual income.
Estimated Dollar Amount
Expense: Mortgage/Rent

Determining Formula: Your remaining outstanding mortgage or estimate of rental costs.
Estimated Dollar Amount
Expense: Outstanding Debt

Determining Formula: Outstanding Loans. Credit card debt, and Other debt.
Estimated Dollar Amount
Expense: College Education

Determining Formula: Estimated cost of college per year, multiplied by four, then by the number of children.
Estimated Dollar Amount
Expense: Emergency Fund

Determining Formula: 25% to 50% of your annual income.
Estimated Dollar Amount
Expense: Funeral Cost

Determining Formula: Approximately $12,500.
Estimated Dollar Amount
Expense: Total available Liquid
Assets

Determining Formula: Cash, Savings, Checking,
Retirement Funds, Existing Life
Insurance, Cnvestments.
Estimated Dollar Amount
3 Referrals
Name of 1st Referral
Contact Number of 1st Referral
Name of 2nd Referral
Contact Number of 2nd Referral
Name of 3rd Referral
Contact Number of 3rd Referral
Emergency Contacts
Name of Emergency Contact
Contact Number of Emergency Contact
Name of Emergency Contact
Contact Number of Emergency Contact
Name of Emergency Contact
Contact Number of Emergency Contact
Additional Information or Specific Needs
When a Spouse dies their income dies but their family need for income continues.

Don’t wait to build your legacy.

📞 Call Devin today for a FREE consultation: 901-457-0389 | 877-645-5829 ext. 708
📧 Or email: devin.riddle@mturnerinsures.com
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