Life Insurance Lead Sample

Below is a sample containing the data fields that we attempt to capture and any leads you purchase at will always be in same column arrangement which is similar to or exactly the below. Each of our vendor's forms have different fields and info each consumer opts to fill in varies but you will always receive at least the required fields below indicated by an asterisk. The leads will be retrievable upon purchase in the orders area in a .csv format that will open right up into an Excel Spreadsheet if you have Excel on your computer. You should be able to print 30-50 leads per excel spreadsheet page depending on font size you select.

Contact Information
Date/Time*: 1/1/2012 12:20
Applicant Name*: John Doe
Street Address*: 1234 Main St.
City*: Los Angeles
Zip Code*: 90016
Phone Number*: (310) 555-1212
Email Address*:
IP Address:
Policy Information
Currently Insured: Yes
Insurance Company: John Hancock
Policy Type: Term
Coverage Amount*: $1,000,000
Term: 30 Years
Declined: No
Occupation: Manager
Self Employed: Yes
Medical Information
Date of Birth*: 1/1/1970
Gender: Male
Height*: 6 Feet 1 Inches
Weight*: 180 Pounds
Pre-existing Conditions: No
Smoker: No
Heart Problems: No
Cancer: No
Other Condition: N/A
Other Condition 2: N/A
Other Condition 3: N/A
Hospitalized Before: No
DUI or DWI Before: No
Current Medications: None
Has Physician: Yes
Comments: In good health
Has Spouse: Yes
Has Children: Yes