1) |
Comments or Details:
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Attribute ID | Attribute Name | Max Length | Mandatory | comments | Comments or Details: | 4000 | false |
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Whare are you located? [required]
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2) |
Attribute ID | Attribute Name | Field Size | Max Length | Mandatory | sendzip | Whare are you located? | 7 | 7 | true | -- OR --
Attribute ID | Attribute Name | Field Size | Max Length | Mandatory | sendcity | Whare are you located? | 15 | 50 | true |
Attribute ID | Attribute Name | Value ID | Value Name | Mandatory | Multi Value | sendstate | Whare are you located? | AL | Alabama | true | false | | | AK | Alaska | | | | | AB | Alberta | | | | | AS | American Somoa | | | | | AZ | Arizona | | | | | AR | Arkansas | | | | | BC | British Columbia | | | | | CA | California | | | | | FM | Caroline Islands | | | | | CO | Colorado | | | | | CT | Connecticut | | | | | DE | Delaware | | | | | DC | District of Columbia | | | | | FL | Florida | | | | | GA | Georgia | | | | | GU | Guam | | | | | HI | Hawaii | | | | | ID | Idaho | | | | | IL | Illinois | | | | | IN | Indiana | | | | | IA | Iowa | | | | | KS | Kansas | | | | | KY | Kentucky | | | | | LA | Louisiana | | | | | ME | Maine | | | | | MB | Manitoba | | | | | MP | Mariana Islands | | | | | MH | Marshall Islands | | | | | MD | Maryland | | | | | MA | Massachusetts | | | | | MI | Michigan | | | | | MN | Minnesota | | | | | MS | Mississippi | | | | | MO | Missouri | | | | | MT | Montana | | | | | NE | Nebraska | | | | | NV | Nevada | | | | | NB | New Brunswick | | | | | NF | New Foundland | | | | | NH | New Hampshire | | | | | NJ | New Jersey | | | | | NM | New Mexico | | | | | NY | New York | | | | | NC | North Carolina | | | | | ND | North Dakota | | | | | NT | NorthWest Territories | | | | | NS | Nova Scotia | | | | | OH | Ohio | | | | | OK | Oklahoma | | | | | ON | Ontario | | | | | OR | Oregon | | | | | PA | Pennsylvania | | | | | PE | Prince Edward Island | | | | | PR | Puerto Rico | | | | | PW | Palau | | | | | QC | Quebec | | | | | RI | Rhode Island | | | | | SK | Saskatchewan | | | | | SC | South Carolina | | | | | SD | South Dakota | | | | | TN | Tennessee | | | | | TX | Texas | | | | | UT | Utah | | | | | VT | Vermont | | | | | VI | Virgin Islands | | | | | VA | Virginia | | | | | WA | Washington | | | | | WV | West Virginia | | | | | WI | Wisconsin | | | | | WY | Wyoming | | | | | YT | Yukon Territory | | |
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3) |
Email Address:
[required]
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Attribute ID | Attribute Name | Field Size | Max Length | Mandatory | email | Email Address: | 35 | 100 | true |
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4) |
First Name:
[required]
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Attribute ID | Attribute Name | Field Size | Max Length | Mandatory | firstnm | First Name: | Not specified | Not specified | true |
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5) |
Last Name:
[required]
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Attribute ID | Attribute Name | Field Size | Max Length | Mandatory | lastnm | Last Name: | Not specified | Not specified | true |
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6) |
Day Time Phone:
[required]
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Attribute ID | Attribute Name | Field Size | Max Length | Mandatory | harea | Day Time Phone: | 3 | 3 | true |
Attribute ID | Attribute Name | Field Size | Max Length | Mandatory | hphone | Day Time Phone: | 10 | 20 | true |
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7) |
Evening Phone:
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Attribute ID | Attribute Name | Field Size | Max Length | Mandatory | marea | Evening Phone: | 3 | 3 | false |
Attribute ID | Attribute Name | Field Size | Max Length | Mandatory | mphone | Evening Phone: | 10 | 20 | false |
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8) |
Best Time:
[required]
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Attribute ID | Attribute Name | Value ID | Value Name | Mandatory | Multi Value | besttime | Best Time: | M | Morning | true | false | | | A | Afternoon | | | | | E | Evening | | | | | T | No Preference | | |
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9) |
cat
[required]
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Attribute ID | Attribute Name | Value | Field Size | Max Length | Mandatory | cat | cat | 605060000 | Not specified | Not specified | true |
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10) |
cmp
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Attribute ID | Attribute Name | Field Size | Max Length | Mandatory | cmp | cmp | Not specified | Not specified | false |
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11) |
lpg
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Attribute ID | Attribute Name | Field Size | Max Length | Mandatory | lpg | lpg | Not specified | Not specified | false |
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12) |
trksrc
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Attribute ID | Attribute Name | Field Size | Max Length | Mandatory | trksrc | trksrc | Not specified | Not specified | false |
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13) |
src
[required]
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Attribute ID | Attribute Name | Value | Field Size | Max Length | Mandatory | src | src | Provided by Respond | Not specified | Not specified | true |
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14) |
You agree to our Terms of Services and acknowledge our disclosures
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Attribute ID | Attribute Name | Value ID | Value Name | Mandatory | Multi Value | acceptedterms | You agree to our Terms of Services and acknowledge our disclosures | Y | Yes | false | false | | | N | No | | |
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15) |
Does your advisor need to be within commuting distance?
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Attribute ID | Attribute Name | Value ID | Value Name | Mandatory | Multi Value | proximity | Does your advisor need to be within commuting distance? | L | Yes, I need a local advisor | false | false | | | R | I am ok with a non local advisor if it is the best match for me | | | | | P | No preference | | |
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16) |
What kind of annuity do you want?
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Attribute ID | Attribute Name | Value ID | Value Name | Mandatory | Multi Value | Q1405160730 | What kind of annuity do you want? | 72744 | Fixed - interest rate resets yearly | false | false | | | 75849 | CD Type - Fixed interest rate for a period of time | | | | | 72746 | Index - Usually linked to a stock index | | | | | 72747 | Variable - Rate of return fluctuates | | | | | 72748 | Don't Know - Looking for advice | | | | | 72749 | Other - Please provide infromation in the details box | | |
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17) |
What are your reasons to purchase an Annuity?
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Attribute ID | Attribute Name | Value ID | Value Name | Mandatory | Multi Value | Q1405160734 | What are your reasons to purchase an Annuity? | 72758 | Secure monthly income for your retirement | false | true | | | 72759 | Choice of payout terms including income for life | | | | | 72761 | Steady guaranteed interest rate | | | | | 72762 | Protection of principal | | |
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18) |
What is your desired initial investment for the annuity?
[required]
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Attribute ID | Attribute Name | Value ID | Value Name | Mandatory | Multi Value | Q1405160735 | What is your desired initial investment for the annuity? | 75841 | Less than $50,000 | true | false | | | 75842 | $50,000 - $100,000 | | | | | 75843 | $100,000 - $250,000 | | | | | 75891 | $250,000 - $500,000 | | | | | 75905 | $500,000 - $1 million | | | | | 77665 | $1 million - $3 million | | | | | 77666 | More than $3 million | | | | | 77667 | Prefer to Disclose Directly to Advisor | | |
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19) |
Your Age Group
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Attribute ID | Attribute Name | Value ID | Value Name | Mandatory | Multi Value | Q1405162044 | Your Age Group | 75845 | 22 to 40 | false | false | | | 75846 | 41 to 55 | | | | | 75847 | 56 to 65 | | | | | 75848 | Over 65 years | | | | | 75844 | Under 21 years | | |
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