Premium Financing Consumer

Premium Financing for Your Whole Life Insurance

If you are a consumer interested in obtaining a free quotation for Premium Financing for Whole Life Insurance from Strategic Wealth Advisors Network, please complete the form below. To learn more about Premium Financing, please read this article: Premium Financing? What is That?
If you have questions or would like to discuss your options further, please call 631-262-9254.
Please note an * symbol indicates a required field.

First Insured

Name of Insured*

Date of Birth*

Occupation*

Smoker*

Yes No

Street Address*

City*

State*

Zip*

Phone (enter as xxx-xxx-xxxx)*

E-mail*

Any known health conditions

If there is a second insured, please continue.

Second Insured

Name of Insured

Date of Birth

Occupation

Smoker

Yes No

Street Address

City

State

Zip

Phone (enter as xxx-xxx-xxxx)

E-mail

Any known health conditions

Life Insurance Information

Life Insurance Need (Purpose)*

Life Insurance Death Benefit Need (Amount)*

Beneficiary Information*

Additional Financial Data

Cash/Cash Equivalents*

Gross Income*

Marketable Securities*

Expenses*

Real Estate*

Net Income*

Business*

Qualified Retirement Plan*

Additional Information*

Other Assets*

Total Net Worth*

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Registered Representative offering Securities through American Portfolios Financial Services, Inc. (APFS) Member FINRA/SIPC. Investment Advisory Services are offered through G&G Planning Concepts, Inc. which is not affiliated with APFS.

Any opinions expressed in this forum are not the opinion or view of American Portfolios Financial Services, Inc. (APFS) or American Portfolios Advisors, Inc.(APA) and have not been reviewed by the firm for completeness or accuracy. These opinions are subject to change at any time without notice. Any comments or postings are provided for informational purposes only and do not constitute an offer or a recommendation to buy or sell securities or other financial instruments. Readers should conduct their own review and exercise judgment prior to investing. Investments are not guaranteed, involve risk and may result in a loss of principal. Past performance does not guarantee future results. Investments are not suitable for all types of investors.