Pre-Qualification Survey

First Name

Last Name

Email

Phone

Billing Address

DOB

Company Name:

Company Website:

Title:

Are You Open to Hedging Your Portfolio With off Stock Market, Principal Protected Allocations?

Yes

No

If I Can Show You How to Lock Money in a 10-Year Fixed Index Annuity and Live off the 6.5% Base Compound Interest, Would You Be Interested?

Yes

No

If I Can Offer You Income for Life or Until 114, Would You Be Interested?

Yes

No

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