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New Clients

If you’ve already spoken with Kyle and want to begin your IBC process with Reese Family Finance, click below and fill out all applicable fields to securely submit necessary and important information to start your process.

New Client

Name

Enter your name as it appears on your Driver's License.

First Name

Last Name

Date of Birth

Enter the date of birth of the proposed policy owner.

YYYY

Sex

Nicotine Use

Do you consume nicotine?

Address

Enter your address as it appears on your Driver's License.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

Enter the phone number at which Kyle can reach you.

(###)

###

####

Bankruptcy

Have you filed bankruptcy in the last 7 years?

Income

Occupation(s)

What work do you do in order to generate income? List all sources and provide a brief description.

Income

Enter the GROSS earned income (salary, wages, commissions, and bonuses before taxes and withholding) that you expect to receive over the next 12 months. This might be whatever your current income is if you do not expect any raises or bonuses over the next 12 months. If you do expect raises or bonuses, you can include them here. This number does not have to be 100% exact, but it should be a reasonable representation of what you expect to earn.

Unearned Income

Enter the GROSS unearned income (dividends, interest, etc. before taxes and withholding) that you expect to receive over the next 12 months. This might be whatever your current unearned income is if you do not expect any increases over the next 12 months. If you do expect increases, you can include them here. This number does not have to be 100% exact, but it should be a reasonable representation of what you expect to receive. If zero, enter "0".

Other Income

Enter any other GROSS income that you expect to receive over the next 12 months that you did not include in the Income or Unearned Income. If zero, enter "0".

Other Income Source

Briefly provide the source of any "Other Income." If none, enter "NA."

Last Year's Income

Enter the GROSS earned income (salary, wages, commissions, and bonuses before taxes and withholding) that you received over the past 12 months. This might be whatever your current income is if you did not experience a significant change in income over the past 12 months. This number does not have to be 100% exact, but it should be a reasonable representation of what you earned.

Last Year's Unearned Income

Enter the GROSS unearned income (dividends, interest, etc. before taxes and withholding) that you received over the past 12 months. This number does not have to be 100% exact, but it should be a reasonable representation of what you received. If zero, enter "0."

Last Year's Other Income

Enter any other GROSS income that you received over that last 12 months that you did no include in Last Year's Earned / Unearned Income. For each entry, briefly indicate its source. If zero, enter "0."

Last Year's Other Income Source

Briefly provide the source of any "Other Income" from last year. If none, enter "NA."

Cash

Enter the sum of cash-in-hand plus cash-in-the-bank. If zero, enter "0."

Stocks and Bonds

Enter, to the best of you knowledge, the sum of the current market value of your stock and bond holdings. If zero, enter "0."

Real Estate

Enter, to the best of you knowledge, the sum of the current market value of all your real estate holdings. If zero, enter "0."

Other Assets

Enter, to the best of your knowledge, the sum of the current market values of other major assets not included in the above categories. This might include the value of automobiles, the value of business ownership positions, the value of precious metals, etc. If zero, enter "0."

Other Asset Value Sources

Briefly state the source of the other assets that you valued above. If none, write "NA."

Statements of Net Worth

Accounts Payable

Enter, to the best of your knowledge, the sum of the current balance(s) of any major accounts payable NOT including your mortgage(s). For example, a student loan balance and (any) automobile loan balance(s) should be entered here. If zero, enter "0."

Sources of Accounts Payable

Briefly state the source(s) of accounts payable, the balance owed, and any other pertinent details for those accounts (e.g. the repayment term, miscellaneous restrictions, etc.). If none, enter "NA."

Mortgage(s) Balance

Enter, to the best of your knowledge, the balance due on any outstanding mortgages. If zero, enter "0."

Mortgage(s) Information

For each mortgage, briefly state the total loan repayment term (e.g. 15- or 30-year), how many years remain in the term, the current market value of the property, and your monthly payment. For example, "30-year, 10 years, $200,000, $1500/month including property tax and insurance." If you pay any insurance or use escrow to withhold property tax, include those numbers in your monthly payment. If you do not use escrow to collect insurance or property tax, write separately what you expect those values to be. If you don't know one or more of these pieces of information, please state the requested field and enter "unknown." For example, "years remaining in the term, unknown."

Existing Life Insurance

Policy Information

For each of your current, in-force life insurance policy where YOU are the insured party, list the company, the amount of death benefit, the type (term, whole, or universal), and the date of issue. For example, "Life-Co., $250,000, whole, 01-01-2019." If you are not the insured party on any current, in-force, life insurance, enter "NA."

Partner's Information

If you are engaged or married, fill in the following information as it pertains to your partner. If you're single, enter "NA" or "0."

Marital Status

Partner's Name

Enter your partner's name as it appears on his or her Driver's License. If single, leave blank.

First Name

Last Name

Partner's Occupation

What does your partner do for a living? If single, leave blank.

Partner's Date of Birth

Enter your partner's date of birth. If single, leave blank.

YYYY

Partner's Nicotine Use

Does your partner consume nicotine? If single, select "NA."

Partner's Income

Enter the GROSS earned income (salary, wages, commissions, and bonuses before taxes and withholding) that your partner expects to receive over the next 12 months. This might be whatever your partner's current income is if you do not expect any raises or bonuses over the next 12 months. If your partner does expect raises or bonuses, you can include them here. This number does not have to be 100% exact, but it should be a reasonable representation of what your partner expects to earn. If zero or single, enter "0."

Partner's Unearned Income

Enter the GROSS unearned income (dividends, interest, etc. before taxes and withholding) that your partner expects to receive over the next 12 months. This might be whatever your partner's current unearned income is if your partner does not expect any increases over the next 12 months. If your partner does expect increases, you can include them here. This number does not have to be 100% exact, but it should be a reasonable representation of what your partner expects to receive. If zero or single, enter "0."

Partner's Other Income

Enter any other GROSS income that your partner expects to receive over the next 12 months that you did not include in your partner's Income and Unearned Income. If zero or single, enter "0."

Partner's Other Income Source

Briefly provide the source of any "Other Income" from last year. If none, enter "NA."

Partner's Existing Life Insurance

For each in-force life insurance policy where YOUR PARTNER is the insured party, list the company, the amount of death benefit, the type (term, whole, or universal), and the date of issue. For example, "Life-Co., $250,000, whole, 01-01-2020." If your partner is not the insured party on any current, in-force life insurance, enter "NA."

Children and Grandchildren Information

If you have children or grandchildren, fill in each field as it pertains to them. If you do not have children or grandchildren, enter "NA."

Do you have any children?

Children Information

List the full legal name and date of birth for each of your children. If none, enter "NA."

Children Insured?

For each in-force life insurance policy you own where your children is the insured party, list the name of the issuing life insurance company, the type of life insurance (e.g. term, universal, or whole life), and the amount of current death benefit. If none, enter "NA."

Do you have any grandchildren

Grandchildren Information

List the full legal name and date of birth for each of your grandchildren. If none, enter "NA."

Grandchildren Insured

For each in-force life insurance policy you own where one of your grandchildren is the insured party, list the name of the issuing life insurance company, the type of life insurance (e.g. term, universal life, or whole life), and the amount of current death benefit. If none, enter "NA."

Preliminary questions for your New IBC-Style Life Insurance

Fill these fields to the best of your ability, keeping in mind that your numbers and answers may change as you work with Kyle.

Based on your current understanding of life insurance build for the IBC, how much premium do you want to pay in total in a year?

Enter one total, combined, annual amount for all premiums. This number may change as you learn more about how premium works in IBC-style life insurance.

Based on your current understanding of life insurance built for the IBC, how many policies do you expect to apply for and who do you intend to insure?

If you intend to self-insure, enter "self." With regard to proposed insureds in whom your insurable interest is not immediately obvious, provide a brief explanation of your relationship to the proposed insured.

In-force Life Insurance Documentation

To receive comprehensive IBC and life insurance advising, please email illustrations for any in-force life insurance you own to kyle@reesefamilyfinance.com.

I will email illustrations of my current policy(ies)

I will not email illustrations for my current policy(ies)

NA - I do not currently own any life insurance

Based on what you currently know about life insurance underwriting, do you expect any difficulty in your getting approved for life insurance?

Yes

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