SAMPLE LIFE INSURANCE LEAD First Name : Lead Last Name : Zumba Address : 11436 173rd Street City : Jamaica State : Ny Zip: : 11434 Phone Number : 888-691-2860 Email Address : contact@leadzumba.com Best Time To Call : Any Time Are you requesting this quote for yourself? : Yes Relation to the person you are requesting for? : Me Do you use Tobacco : No What type of tobacco products : N/A Height : 6" 1' Weight : 98 Gender : Male Date of Birth : 10/22/52 Amount of insurance wanted : $1,000,000 - $2,000,000 Type of insurance wanted : Whole Life Primary purpose(s) : Income to family in case of death What term would you like : 99 Amount of Insurance now in force : $750,000.00 Premium you are paying per year : $7,500.00 When is the last time you applied : Longer than 5 years ago What Was The Outcome : Accepted Health Problems : Moderate Cholesterol Any Medications : None Names/doses : N/A Any Family members with Heart Disease / Cancer : None Please Describe : N/A