Sample Auto Insurance Lead For Tom Agent Type Auto Quote by ramhood1

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									Sample Auto Insurance Lead


                                                                                    For: Tom Agent
                                                                                      Type: Auto
                                                                                  Quote Needed: ASAP




                                              Contact Information
                Name: Jim Customer                                      Email: Customer’s Email address
             Address: 123 Sample Lane                         Daytime Phone: (123) 234-0934
                          Anywhere, CA 90012                  Evening Phone: (123) 234-4523
     Time to Contact: Afternoon                                            Fax: (123) 690-6574
           Additional
          Comments: I need this quote ASAP!


                                     Insurance and Liability Information
   Currently Insured: Yes                                       Garaging Zip:90104
           Company: Nationwide                                Yrs at Current
                                                                Residence: 1-2 years
Time with Company: 6 months - 1 year                      Household Income: $50,001-$100,000
    Continuous Cvg: 5+ years                                   Credit History: Good
     Policy Renewal:Jun 15, 2008                               Owns Home?: Own
   Current Payment: $100 monthly
     Current Liability                                       Desired Liability
               Limit: $100,000/$300,000/$50,000                        Limit: $250,000/$500,000/$100,000
     Uninsured Cvg: $250,000/$500,000                              Med-Pay: None
       Rental Reimb: Yes                                       Roadside Svc: Yes


                                     Driver Information - Jim Customer
                Name: Jim Customer                                  License #: AL 999999999
      License Status: Active
        Date of Birth:May 5, 1974                               Social Sec. #: 999-99-9999
              Gender: Male                                Licensed in the U.S.
                                                                          for: more than 5 years
       Marital Status: Married                                   Occupation: Attorney
     GPA, If Student:                                        Education Level: Doctorate



                                        Driving Record - Jim Customer
    Major Violations:               DUI: No             Lisc Susp: No          SR-22:No
 Violations in the last
              3 years:
                               Driver Information - Anne Customer
               Name: Anne Customer                           License #: AL 123456789
Relationship to Jim: Spouse                                  License Status: Active
       Date of Birth:Jul 12, 1974                                Social Sec. #:999-99-9999
             Gender: Female                                      Age Licensed:16
      Marital Status: Married                                     Occupation: Student, getting doctorate
    GPA, if student :3.9                                    Education Level: Masters
                                      Driving Record - Anne Customer
   Major Violations:                DUI: No            Lisc Susp: No          SR-22: No
Violations in the last          Date: 01/05            Type: Minor Violation (Speeding, Running a stop
             3 years:                                  sign, etc.)
                                              Auto Information
             Vehicle: 2005 TOYOTA CAMRY XLE 4-               Primary Driver : Jim Customer
                     CYL
                VIN: 680F2142TB6529                                 Fuel Type: Gas
              Doors:4                                               Main Use: Commute to Work 5-10 miles
        Deductibles: $250 Comp. / $250 Coll.                 Leased/Owned: Owned
   Has the following
           features: Four Wheel Drive, Anti-Theft Device, ABS, Airbags

								
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