---- Automobile Lead Sheet ----

TEL-AMERICA TELEMARKETING  |  PO Box 26, Franklin Square, NY 11010  |  Tel 516 437-4242  |  Fax 516 775-9413
 
MARRIED   
 
SINGLE   
 
YOUR AGENCY

Hello, this is____________, calling from Your Agency. The reason for my call is we would like to offer you a quote on your auto insurance. By comparing top auto companies in our computer, we can get you the best rate and possibly save you 15% or more. What I'd like to do is ask you a few quick questions so we can show you how much you can save.
 
CAR 1
CAR 2
CAR 3
CAR 4
MODEL YEAR
 
 
 
 
 
MAKE (Chev, NISSAN..)
 
 
 
 
 
MODEL & DESIGNATION
(Malibu-LE, Sentra-SE..)
 
 
 
 
Is car driven to work?
Distance One Way?
 Y / N
Distance________
 Y / N
Distance________
 Y / N
Distance________
 Y / N
Distance________
COLLISION Y / N
Deductible______
 Y / N
Deductible______
 Y / N
Deductible______
 Y / N
Deductible______
Liability Limits (Injury)
25/50  50/100  100/300  250/500   Property Damage 10 / 25 / 50 / 100
MALE DRIVERS
Age / # Years Licensed
/
/
/
/
FEMALE DRIVERS
Age / # Years Licensed
/
/
/
/

Has Any Member Of Your Household Had Any Accidents Or Tickets In The Past 5 Years?   Y   N

If Yes How Many? ____________ What Type & When _____________________________

__________________________________________________________________________

What Company Currently With? __________________ Renewal Date _________________

A representative of Your Agency will call you tomorrow. Please have your current policy "on hand" so that the agent can make an accurate comparison.

BEST TIME TO CALL ________________________________________________________

SPOKE TO:
_________
Mr./s.
 / _______________________________________________________
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Caller______________________________________Date____________________________

Call Date Representative NOTES