Producer Closing - ALLCHOICE Insurance

LEAD SOURCE INFORMATION

Where Did This Client Come From?*

Who Referred You?

First Last

Referral Notes

Please include relevant info on the referral - was it a current client, another insurance agent, loan officer, realtor, closing attorney, etc

PRODUCER*

What Type Of Insurance Are You Looking For?*

Insured Name

First Last

Business Name

Primary Business Contact

First Last

Mobile Phone

Email

Effective Date

Personal Policy Type(s)

Business Policy Type(s)

Life & Health Policy Type(s)

Pay Plan

Provide Pay Plan Selected

Coverage Limit(s) & Options Confirmation & Notes

Please make sure we know what coverages or options are needed (if multiple options were presented)

Carrier / Brokerage Notes

Provide any relevant info if you spoke with an Underwriter about risk (example - % credit authorized by underwrite)

Post Issuance Notes

Do we need to do anything special for the customer after issuance (send cancellation request | immediate COI needs | etc)

All Other Notes

Put anything else you want here

Attach Relevant Files

Drop files here or

Includes Proposals, Other Carrier Decs, any file that you want in the management system