Open Form FE Form Name * First Name Last Name Email * Phone (###) ### #### What type of life insurance policy do you have currently? * Whole life Term UL Not sure Who chose the amount of coverage and type of insurance? You or Agent? Why? * Date purchased? * Has the premiums stayed: * Level Increased Decreased Stopped Have you taken a loan on the policy? When was the last time you did a full review and update of your life insurance policy? Do you understand the paid-up insurance option and loan value statement for this year? Have you ever called the carrier and confirmed your policy will not lapse before you pass away? What do you think the cost of a funeral or cremation is today? What about 5 years ago? What do you think it will be in 5 years? Have you ever helped plan a funeral? Who? Did they have enough coverage? If your policy did not cover the full amount, who would pay the difference and how? Besides covering the funeral or cremation, is your policy intended to cover any other expenses? if so please explain: Did you know if your policy is 5 years old or older, you may qualify for either a reduction of premium or a cost-of-living increase on your life insurance? What would help you more? Reducing your monthly premium and keep your coverage amount the same? Or keep the same premium and have a cost-of-living increase on your coverage amount? How did you hear about us? * (if referred, please list name) Thank you! Final Expense QuestionnaireThe following Questions are asked only to make an educated recommendation
