Needs Analyzer

Disclaimer and Notice: Results of a Needs Analyzer will only give a rough estimate of potential insurance needs. Clients should contact our office, complete a Fact Finder and discuss their particular goals with an agent.

Name(Required)

First Last

Email(Required)

Phone(Required)

Best Time To Call(Required)

Morning

Afternoon

Evening

Other

Income to be replaced if death occurred(Required)

ie. $50,000 / year

Estimated combined Federal & Provincial annual tax rate(Required)

ie. 45%

Number of years required for income to be replaced(Required)

Examples: Until age 65, until age 80, until children have finished post secondary school, until mortgage is paid

Estimated annual rate of return(Required)

What rate of return would you expect from a conservative investment portfolio over a 30 year period? ie. 4%

Estimated inflation rate(Required)

What do you expect the average inflation rate to be over the next 30 years? ie. 2%

What percentage of your net family income is spent entirely on you and not on combined family expenses(Required)

Examples: your car payment, your car insurance, memberships, and leisure expenses. ie. 40%

Additional Information

Is there any additional info you would like to include?

Phone

This field is for validation purposes and should be left unchanged.

Name *

Email *

Telephone *

Birth Date

Province

Gender Male Female

Have you smoked in the past 12 months? No Yes

Health Risk

Amount of Insurance

Payment Schedule

Product Type

* Indicates required field
* The quoting process is only a quote and subject to further medical and underwriting requirements

Call us to discuss your insurance needs today.

CALL 519.401.9504