Key Employee Life Insurance

Contact me regarding key employee coverage.

I am interested in the following type(s) of life insurance:
Not Sure
Term Life: 5-Year 10-Year 15-Year 20-Year 30-Year
Universal Life Variable Universal Life Whole Life

List key employee(s) to be covered:
Name
Date of Birth Male Female Tobacco User Non-Tobacco
Name
Date of Birth Male Female Tobacco User Non-Tobacco

Contact me regarding life insurance to fund a Buy-Sell Agreement.

I am interested in funding this agreement with the following type of life insurance:
Not Sure
Term Life: 5-Year 10-Year 15-Year 20-Year 30-Year
Universal Life
Variable Universal Life
Whole Life

Amount of Insurance

Number of Partners / Co-Owners

List all partners / co-owners (including yourself):
Name
Date of Birth Male Female Tobacco User Non-Tobacco
Name
Date of Birth Male Female Tobacco User Non-Tobacco
Name
Date of Birth Male Female Tobacco User Non-Tobacco
Name
Date of Birth Male Female Tobacco User Non-Tobacco

Contact me regarding the following type of retirement plan:

Not Sure
Simplified Employee Pension Plan (SEP-IRA)
Simple IRA Plan
Profit Sharing Plan (KEOGH Plan)
Money Purchase Pension Plan (KEOGH Pension Plan)
Age Weighted or Comparability Plan
Defined Benefit Pension Plan
"One-Person" 401(k) Plan
401(k) Plan
Safe Harbor or DASH 401(k) Plan
403(b) Plan

Number of Employees