Life Insurance Needs Analysis

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Only if you desire, once the quiz is completed, you will have an opportunity to reach out and speak with a Real Person located in Wayne and not just a computer. Most studies show that when searching for life insurance coverage, the majority still want to speak with a real person!

At the end of this quick quiz, please enjoy the instant and free download our clients consider one of their favorite tools to use for their financial planning, our Life Folio Booklet along with your Instant Quotes!

See you in 60 seconds!
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FaceBook Pixel
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Lets start with an easy one, what's your First Name?* This field is required.
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What are your 3 Biggest Goals?
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What is your Biggest Personal Goal?
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What is your biggest financial goal right now?* This field is required.
Saving More
Student Loans
Retirement
New Home
Next Mortgage / Rent Payment
Retirement
Holiday Shopping
Next Vacation
College Funding
Home Improvements
Child Care
Long Term Care
Legacy Planning
Grocery Shopping
Other
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Who would you leave everything to?
Spouse
Significant Other
Children
Parents
Siblings
Friend
Partner
Relative
Other
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On a scale of 1 to 10, is Planning for the future very important to you?
Please Select
Please Select
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Would you like to explore ideas on how to save more money each year?
Yes
No
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Do you feel taxes will be higher in the future?
Yes
No
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Life Insurance Needs Analysis (how much do you need?)
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1. Final Expenses (Funeral expenses, Medical expenses, Attorney/Executor fees, potential Hospital expenses, the national average ranges from $10k-$25k)* This field is required.
Please Select
Please Select
$5,000
$10,000
$15,000
$20,000
$25,000
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2. Approximate Annual Income* This field is required.
Please Select
Please Select
$20,000
$25,000
$30,000
$35,000
$40,000
$45,000
$50,000
$55,000
$60,000
$65,000
$70,000
$75,000
$80,000
$90,000
$100,000
$110,000
$125,000
$150,000
$175,000
$200,000
$250,000
$300,000
$350,000
$400,000
$500,000
$750,000
$1,000,000
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3. What is your Debt? (credit cards, auto or student loans, not your mortgage) 50% of your annual income is recommended* This field is required.
50%
Please Select
0%
5%
10%
25%
50%
100%
150%
200%
300%
400%
500%
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4. Emergency Expenses (3-6 months salary is recommended)* This field is required.
50%
Please Select
0%
5%
10%
25%
50%
75%
100%
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5. Approximate Mortgage Amount to Payoff (Or 5 to 10 years of your current Rent)* This field is required.
Please Select
Please Select
$0
$25,000
$50,000
$75,000
$100,000
$125,000
$150,000
$175,000
$200,000
$225,000
$250,000
$275,000
$300,000
$325,000
$350,000
$375,000
$400,000
$450,000
$500,000
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6. Do you have any children?* This field is required.
Please Select
Please Select
Yes
No
We will have one soon
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6a. How many children do you have?* This field is required.
Please Select
Please Select
1
2
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4
5
6
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6b. Do you want your child/children to attend: (i.e. State College for $20k/yr, Out of State College for $25k/yr or a Private University for $50k/yr, or They're paying for themselves)
Please Select
Please Select
$0
$20,000
$25,000
$50,000
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6c. What is the age of your 1st child?* This field is required.
Please Select
Please Select
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6d. What is the age of your 2nd child?* This field is required.
Please Select
Please Select
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6e. What is the age of your 3rd child?* This field is required.
Please Select
Please Select
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6f. What is the age of your 4th child?* This field is required.
Please Select
Please Select
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6g. What is the age of your 5th child?* This field is required.
Please Select
Please Select
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6h. What is the age of your 6th child?* This field is required.
Please Select
Please Select
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7. Income Replacement: (You should provide between at least 5 to 10 times your annual income).* This field is required.
Please Select
Please Select
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7. Income Replacement: (How much of your annual income do you want to leave your beneficiary, 3-6 months, 1x your salary, 5 x your salary?)* This field is required.
Please Select
Please Select
0
0.25
0.50
0.75
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Final Expenses (national average $10k-$25k)
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Debt Liquidation (credit cards, auto or student loans, not your mortgage) 50% of your annual income is recommended
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Emergency Expenses (3-6 months salary)
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Approximate Mortgage Payoff Or 5-10 years of Rent
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Child Care (usually a min of $500/mo per child until the age of 15)
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College Funding ($20k-$60k/year per child, for 4 years)
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Income Replacement:
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Where should we send you your customized confidential report, what is your E-mail?* This field is required.
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Total Life Insurance Needs
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What is your age (optional, but preferred for more detailed feedback)?Remember to hit SUBMIT for your Instant Quotes!
Enter your age and hit submit to get your Instant Quotes!
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