Simply Zest Fact Find
Complete Below To Produce Client Pack
Number of Customers
Select
1
2
Insurance Type
Select
Life
Life and CIC
CIC
IP
NFIP
Over 50
Other
Sale Route
Select
Underwrite Me
Direct
Fact Find
Other Insurer
Insurer
Select
AIG
Aegon
Scottish Widow
Royal London
Vitality
LV
Shepherds
National Friendly
L&G
HSBC
The Exeter
Aviva
Met Life
Other
Current Address
Previous Address if Under 3 years
Customer 1
Combined Net Monthly Income
Combined Gross Annual Income
Job Title
Combined Monthly Outgoings
Residential Status
Select
Homeowner Mortgage
Homeowner No Mortgage
Living with Family
Tenant
Other
Mortgage Balance
Mortgage Term
Is The Mortgage Joint
Select
Yes
No
Is it C&R or IO
Select
Capital and Interest
Interest Only
Marital Status
Select
Single
Married
Divorced
Separated
Co-habiting
Widowed
No Of Dependents
Select
0
1
2
4
4
6
6
8
8
9
Age of Dependents
add a "," between each value
Nationality
Select
British
Other
Other Nationality
Customer 2
Annual Salary
Nationality
Select
British
Other
Job Title
Existing Deal If Applicable
Existing Cover?
Select
Yes
No
Exisitng Insurer
Select
AIG
Aegon
Scottish Widow
Royal London
Vitality
LV
Shepherds
National Friendly
L&G
HSBC
The Exeter
Aviva
Met Life
Smart
Other
Existing Term
Existing Monthly Premium
Existing Sum Insured
Existing Type
Select
Life
Life and CIC
CIC
IP
NFIP
Over 50
Other
Exisitng Cover Term Type
Select
DTA
LTA
Demands and Needs
Why did you choose provider
Select
Cheapest
Ex Pat
Medical
Financial Limits
Armed Forces
Lifestyle
Preference
Why did you choose term
Select
Retirement
Max within budget
Max available
Mortgage
Children age non dependent
Preference
Why did you choose amount covered
Select
2 times salary
10 times salary
Mortgage
Funeral
IHT
Preference
Other
Purpose of cover
Select
Mortgage
Partner
Kids
Protect Income
Preference
Other
Did you discuss impact of future income and expenditure changes
Yes
No
Is the monthly expenditure over 85% of the net income
Yes
No
Is the policy to be put in Trust?
Yes
No
Any other information
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