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EasyIssue
               3 - 12 Minutes per Client

Term / Impaired Risk / Guaranteed Issue

One Source Portal

Electronic Submissions

Minimal Paperwork

On-line Access

Its Never Been Easier

Time is Money
Agent Name: 
Phone: 
Res State: 
License # 

       
 

The Questions Below are Specific to Banner Life

Please answer each questions and then click the 'Submit' button. Your answers will be electronically forwarded to a contracting team member, who will fill in your contracts for you and fax you any necessary signature pages It's that easy!

   
Yes
No
 
 
 Do you have any unsatisfied judgements, garnishments or liens against you?
 
 
 Are you in debt to any insurance company?
 
 
 Have you ever filed or been declared bankrupt or insolvent either personally or in business?
 
 
 Have you ever been charged with, convicted or , or please no contest to:
 
 
a)
  any felony or misdemeanor?
 
 
b)
  any violation of any state insurance regulations or related regulations?
   
c)
  any violation of federal or state securities or investment related regulations?
   
Are you now or have you ever been the subject of any insurance or investment related customer complaint, investigation or proceeding?
    Have you ever had your contract or appointment terminated or refused by any insurance or financial services company?
    Have you ever had a license denied, revoked or suspeneded by any Securities and/or State Insurance Depoartment?
    Have you ever used any other names or aliases?
    Ever been contracted or associated with Banner Life or William Penn?
   

        
     


Contracting Questions - Call

   

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