---- Life Insurance Lead Sheet ----

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

Hello, this is____________, calling from Your Agency. How are you today? We are calling to follow-up on a letter we recently sent you regarding very affordable "Level Best" Term Life Insurance. What I would like to do is ask you a few quick questions so our Life Specialist can call you with a no obligation quote.

1. Do you have life insurance that protects you or your spouse? ____YES   ____NO

2. Do you own other personal life insurance? ____YES   ____NO

3. Date of Birth: ______/______/______/.

4. Are you a ______SMOKER or ______NON-SMOKER

SPOKE TO:
_________
Mr./s.
 / _______________________________________________________
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A representative of Your Agency will call you tomorrow.

BEST TIME TO CALL ________________________________________________________

Caller______________________________________Date____________________________

Call Date Representative NOTES