Agent Requests - Unbridled Wealth

What do you need support with?*
Client Name*
First Last
Name of Client #1*
First Last
Name of Client #2*
First Last
Client Email(s)*
Insurance Carrier*
Please put the name of the Insurance Carrier you are wanting to use*
Formal or Informal Underwriting?*
Has the client or clients completed the Informal Inquiry & HIPPA form?*
- Yes!
The Admin team will fill out the application once BOTH the Informal Inquiry & HIPPA Form are received.
Has the client or clients completed App Data?*
- Yes! It's ready to go!
The Admin team will start the application once App Data is received.
Product Type*
Ameritas Product Type*
Please select whatever product you think the client will purchase after everything's said and done.
Death Benefit Amount*
Type of WL*
Please select the WL type.
Type of IUL*
Please select the IUL type.
Length of Term*
Please select the number of years desired.
Annualized Premium*
Death Benefit Option*
How much Death Benefit is being allocated to the WL?*
How much Death Benefit is being allocated to Term?*
How much Death Benefit is being allocated to the IUL?*
Life Insurance Qualification Test*
Have you filled out and saved an allocation form into OneDrive?*
- YES
Is the Primary Insured the Policy Owner?*
If no, please list the policy owner
Occ Class Quoting*
Amount of DI applying for (monthly):*
Underwriting Details*
Amount of BOE*
Term Policy Number*
Please check this box when App Data Term Conversion form is complete and in the client's OneDrive folder*
- Yes! It's ready to go!
Is this a 1035?*
Is there a loan on the policy you are transferring?
Is form UN 1799 (Application for Evidence of Insurability) required, completed, and in their OneDrive folder?*
Only questions 6 (A-I) and complete Health Questionnaire need to be completed in form UN 1799 - signatures not required.
Are you splitting the case with someone?*
Please list any other strategist names and split percentages below.*
Will this be accelerated underwriting?*
Accelerated Underwriting means the client will fill out a health questionnaire instead of doing a med exam.
Has the client(s) completed App Data?*
- Yes! It's ready to go!
The Admin team will start the application once App Data is received.
Has the client(s) completed the App Data and Health Questionnaire?*
- Yes! They are ready to go!
The Admin team will fill out the application once App Data and a Health Questionnaire are received. Please don't submit this form until those are complete.
Have you filled out the Producer App Data?*
Please click here to fill out the Producer Annuity App Data
Has the owner of the juvenile policy filled out the Juvenile Supplemental form?*
- Yes! It's ready to go!
Did you complete the Producer App Data?*
- Yes! It's ready to go!
The Admin team will fill out the application once BOTH the Client's App Data and the Producer App Data are received. Please don't submit this form until those are complete.
What state do you need to get licensed in?*
Which lines of authority?*
- Life
- DI
- Both please!
Realistically, when do you expect to have an application ready to submit in the state listed above?*
Candidate Name*
First Last
Candidate Email*
Does the candidate have any current Life or L&H license?*
Candidate Resume
Max. file size: 150 MB.
Why would this candidate be a good fit with Unbridled Wealth?*
Name (as you'd like it on your cards)*
First Last
Phone (number will appear on card)*
Phone Qualifier*
- M (mobile)
- D (direct)
This will go in front of your area code. Ex: M 303-333-3333
Email*
Address (where we'll mail your cards)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Please include the following address on my card:
- Wealth Headquarters
- The address I listed above
- A separate address (below)
- Please leave blank
Separate Address (not strategist's mailing address & not HQ)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Please explain the illustrations you are requesting*
Example: show maximum non-MEC PUAS in current year, show maximum non-MEC premium for next "x" years, show reducing premiums for "x" years, etc.
Policy Number*
Is the client in New York?*
Please click here to fill out an EFT
Please click here to fill out an EFT
Please confirm you filled out the EFT*
- Yes! I clicked the EFT link and filled it out. It's ready to send to my client for signature.
Is the client in New York?*
Please click here to fill out the loan form
Please click here to fill out the loan form
Please confirm you filled out the Loan Request*
- Yes! I clicked the Loan link and filled it out. It's ready to send to my client for signature.
Notes
No penalties for too many notes! Help us help YOU! 🙂
Requested by*
Receive Confirmation Email*

Call Today To Schedule Your Free Consultation: (303) 957-9175

No one is born financially savvy. At Unbridled Wealth, we craft strategies tailored to how much money you make, giving you the peace of mind knowing that your financial future is more attainable than you think.

CONTACT US

1400 Josephine Street | Denver, CO 80206

[email protected]

(303) 957-9175

Call Today To Schedule Your Free Consultation: (303) 957-9175

CONTACT US

©2020 Unbridled Wealth, LLC.Privacy Policy

CONSULTATION | EDUCATION | EVENTS

CONSULTATION | EDUCATION | EVENTS

©2020 Unbridled Wealth, LLC

Privacy Policy