| * First Name: |
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| * Last Name: |
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| * Work Email: |
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| * Business Phone: |
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Understanding Your Business
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| * How do you obtain new clients?: |
Referrals from Existing Clients
Attorney or CPA Relationship
Direct Marketing
Group Seminars
Other:
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| * Annual Paid Annuity Premium: |
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| * Carriers Licensed: |
Allianz
Allianz Preferred
American Equity
Americo
American National
Athene Annuity (AVIVA)
Baltimore Life
Bankers Life
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Genworth
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Integrity
Legacy
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NACOLAH
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Principal
Reliance Standard
Sagicor
Security Benefit
Sentinel Security
One America
Symetra
The Standard
Transamerica
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| * Number of IMOs You Are Contracted With: |
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| Number of Clients Advised by Agent: |
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| Securities Licensed - Broker-Dealer Name: |
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| Date of Last Submitted Annuity Application?: |
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| Why do you work with an IMO?: |
Agency Tools
Service & Relationship
Programs & Lead Generation
Software & Calculators
Carrier & Product Availability
Other:
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