HomeTech Supporttrade leadsmailing listbuy / sell leads
Welcome to LeadExchange
How to use LeadExchangeTradingRoom FloorHow to beginSign Up NowAbout usTerms of useJob OpportunitiesPress ReleasesTestimonials

Member Name:


With LeadExchange™ working for you, you'll have confidence that the leads that your web site produces are only from interested consumers.  Below you'll find a sample Annuity lead.  All consumers are required to fill out a standardized questionnaire in order to be considered a valid lead.  To return, please click here

Beyond tax advantages, there are important reasons to invest in an annuity!
For example, annuities can provide for...

Guaranteed income
An annuity can provide you with a guaranteed lifetime income, regardless of how long you live. No other investment instrument can provide this guarantee..

Instructions:  Please fill in this form as completely as possible in order to ensure that your quote will be as accurate as possible.

First Name


Last Name


Street Address






Zip Code


Day Phone


Evening Phone


E-mail Address


Best time to call:


Who is this quote for?




Birthday (mm/dd/yy)


Your tax bracket:


Amount of money you
want to invest: (note $5,000 is a typical minimum)


If this is not a lump sum investment,
how much do you plan to add to
the annuity?


How often will you deposit
additional funds?


If any funds are coming from a
Tax Qualified account, what
type of account is it?
(leave blank if irrelevant)


If any funds are coming from a
Non-Tax Qualified account, what
type of account is it?
(leave blank if irrelevant)


If funds are coming from
a CD, what month does it come due?


Primary consideration influencing
annuity purchase:


Other consideration influencing
annuity purchase:


How long would you like your
annuity to grow before
receiving income payments?


Would you like an additional quote for any of the following insurance products?

 Life Insurance
 Disability Insurance
 Long Term Care Insurance
 Health Insurance
 Group Health Insurance
 Auto Insurance
 Homeowners Insurance
 Home Loans