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Life Insurance Calculator
Welcome to Your Future
Most people want to have a sound financial future but do not know where to start. Today is your first step towards achieving financial independence.
Fill out the information below and we will provide you with an array of financial strategies to help you achieve your goals and dreams
Your Name
Cell Phone Number
Your Email Address
State of Residence
What is Your Spouse's Name?
How Old is Your Spouse?
How Many Children Do You Have?
What are the Ages of Your Child(ren)?
What Area(s) Are you MOST Concerned About?
Budgeting
Cash Flow
Debt Elimination
Emergency Funds
Proper Life Insurance
Retiring Properly
Estate Planning (Will, Trust, etc)
When was Last Professional Review?
First Time
1-3 Years Ago
3-5 Years Ago
5+ Years Ago
When was Last Professional Review?
Do You Have an Established Monthyl Budget?
Yes
No
Need One
Do You Have an Established Monthyl Budget?
What is Your Household Post-Tax Income Each Month?
What is Your Total Monthly Expenses?
# of Months of an Emergency Fund You Want Saved?
3 Months
6 Months
12+ Months
# of Months of an Emergency Fund You Want Saved?
How Much Do You Have Saved for an Emergency?
Do You Feel Like You Live Paycheck to Paycheck?
Yes
No
Do You Feel Like You Live Paycheck to Paycheck?
How Much Total Debt Do You Have?
How Much a Month Do You Pay Towards Debt?
Do You Want a Debt Elimination Plan?
Yes
No
Do You Want a Debt Elimination Plan?
How Much Life Insurance Do You Have?
What Type of Life Insurance Do You Have?
Term
Whole Life
IUL
VUL
Final Expense
It's Through Work
Unsure
None
What Type of Life Insurance Do You Have?
How Much Life Insurance Does Spouse Have?
What Type of Life Insurance Does Your Spouse Have?
Term
Whole Life
IUL
VUL
Final Expense
It's Through Work
None
What Type of Life Insurance Does Your Spouse Have?
How Much Life Insurance Do Your Kid(s) Have
What Type of Life Insurance Do Your Kid(s) Have
Term
Whole Life
IUL
VUL
Final Expense
It's Through Work
None
What Type of Life Insurance Do Your Kid(s) Have
What is Your Monthly Cost of Life Insurance?
At What Age Do You Want to Retire?
How Much Do You Have Saved for Retirement?
Where is Your Retirement Saved?
Bank
IRA
Roth IRA
401(K)
403(B)
457
Life Insurance Retirement Plan
Other
If Other Retirement Savings, Where?
How Do You Feel About Your Plans for Retirement?
Do You Have Any of the Following for You?
Will
Trust
Medical Proxy
Power of Attorney
None- But Want
Do You Have any Old Company Retirement Plans?
Yes
No
Unsure
Do You Have any Old Company Retirement Plans?
To Meet Your Goals, Total You Can You Save Monthly?
Who Referred You?
Any Reason You Would NOT Take the Advice Given?
No
Yes
Any Reason You Would NOT Take the Advice Given?
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