Debts, Income, Mortgage, Education

First Name:*

Last Name:*

Email:*

Student Loans:*

Car Loans:*

Credit Cards:*

Monthly:*

Monthly:*

Monthly:*

Total:*

Total:*

Total:*

What do you think your house is worth (in dollars)?

What is your current balance on your home mortgage (in dollars)?

Current Balance #2 (in dollars):

Monthly Payment (in dollars):

Type of Loan:
FixedAdjustable

Interest Rate (in percentage):

Number of Years:

Approximate Cost for Education (in dollars):*

Amount Saved (in dollars):*

Client Name:*

Type:*TermWhole LifeIndexUniversal

Policy Amount:*

Monthly Payment:*

Client's Carrier:*

Spouse Name:*

Type:*TermWhole LifeIndexUniversal

Policy Amount:*

Monthly Payment:*

Spouse's Carrier:*

Date of our next meeting:

Time:

BPM: