Dial: 0 Ask: 0 Quote: 0 Appt Set: 0 X-Date: 0 Email: 0 Dial Success Rate: 00 Ask Success Rate: 00 Activity ID: 0
Customer ID: 0
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Agency Your Leads Action Dates List Renewal Source < > Access:
Showing all records
Applicant
Name: Gender:
Address: DOB:
City/St Zip: / Email:
Home Phone: Occupation:
Cell Phone: Marital Status:
Work Phone: Education:
       
Co-Applicant
Name: Gender:
Cell Phone: DOB:
Work Phone: Email:
Occupation: Relation:
Education:    
How many vehicles do you insure?
Year: Make:Loading gif Model:
Year Purchased: Vehicle Use: Damaged/Salvage Title:
VIN (0): Titled To: Annual/To Miles:
Driver: Ownership: Coverage:
Original Owner: Rideshare: Gap Insurance:
Expect OEM: Is the loan balance higher than the blue book?
Custom Equipment: Suspension Lifted:    
Note:
Are you open to getting more discounts by allowing a telematic device to track your driving habits?
Do you have AAA? If no, would you expect your insurance to pay towing or roadside assistance expense?
If your vehicle is in the body shop as a result of an accident, would you expect your insurance to pay your rental car expense?
If your windshield needed to be replaced today, how much would you want to pay?
If your vehicle was vandalized, you hit an animal or had hail damage how much of a deductible are you willing to pay towards those repairs?
If your vehicle was damaged from a collision with another vehicle or object, how much of a deductible are you willing to pay towards those repairs?
Would you be interested in going to higher deductibles to reduce premium?
What's the most you'd be willing to pay?
Do you have health insurance?
What would best describe your financial situation?
Paying your premium in full can get you a pretty big discount, so I was wondering if paying your premiums every 6 months or annually an option?
Do you have an umbrella policy?
How many drivers?
How does your/their name appear on your/their driver's license?
First Name: Last Name: Gender:
DOB: Drivers License: DL State:
Relation: Email: Cell:
Rated Status: DL Status: Defensive Driver:
Education: Student > 100 miles:    
Discounts:    
SR 22: SR 22 Start Date: SR 22 End Date:
Note:
How many accidents have you had in the 3 to 5 years?
How many tickets have you had in the 3 to 5 years?
How many comp losses have you had in the 3 to 5 years?

Do you own or rent your home?

Is your home an apartment, condo, townhouse, multi family, or single family dwelling?

Replaced By Resident Type
Purchased (M/Y): Number of occupants? In a HOA?
If less than 2 years, what was your previous address:
Previous Address: Previous City/State: / Previous Zip:
Dogs Count: Breed:    
 
Building Information
Address: City/State: / Zip:
Year Built: Foundation: Pct Finished:
Sump Pump:        
Stories: Sq Feet: Style:
Fire Hydrant: Fire Station: City Limits:
 
Exterior Information
Roof Material: Roof Replaced: Impact Resistant
Roof Replacement: Sewer Concern? Solar Panel Cnt:
Exterior Walls: Garage: Garage Sizes: Cars
Deck: Sq Ft   Patio: Sq Ft   Porch: Sq Ft  
Hot Tub: Pool: Trampoline:
Detached Structure: Detached Structure: Detached Value:
           
Interior Information
Kitchen Grade: Bathrooms: - Full - 3/4 - 1/2 Bath Grade:
Flooring: Hardwood   Carpet   Tile   Laminate   Vinyl      
Fireplace: #   Wood Stove: Last Inspected:
Heating: Heating Updated: Central Air:
Plumbing: Updated: Wiring: Updated: Household Smoker:
           
Home Features
Dead Bolts: Burglar Alarm: Fire Alarm:
Protective Device: Home Business: Equipment Coverage:
Floaters: $ Jewelry   $ Firearms   $ Collectibles
Do you plan to buy a new home or refinance in the near future? What year?
Losses:
Notes:
Move In Date (M/Y): Number of occupants?    
If less than 2 years, what was your previous address:
Previous Address: Previous City/State: / Previous Zip:
Dogs Count: Breed:    
 
Building Information
Address: City/State: / Zip:
Personal Property Unit Sq Ft: Year Built:
Floaters: $ Jewelry   $ Firearms   $ Collectibles
Do you plan to buy a new home or refinance in the near future? What year?
Notes:
Current Auto Coverage:
Carrier: How Long: Premium:  
Renewal: Renewal Cycle: Pay In Full:
Limits: / Uninsured: Medical:
Note:
Current Homeowners Coverage:
Carrier: Premium: Renewal:
Dwelling: Other Structure: Personal Property:
Liability: Medical: Loss Of Use:
Deductible: Deductible (Wind/Hail): How Is It Paid:
Water Backup: Replacement Cost: Extended Dwelling:
Floaters: $ Jewelry   $ Firearms   $ Collectibles
Note:
Current Renters Coverage:
Do you have renters insurance?
Carrier: Deductible: Renewal:
Personal Property: Liability:    
Premium: How Is It Paid:    
Floaters: $ Jewelry   $ Firearms   $ Collectibles
Note:

Production Report:

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Date: (from) (to) IssuedWrittenLog ResultBonus Paid
Filters: Search: Grace Period: Days Count All:
First Name:
TRACKING IS OFF!
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Hopeless 0 0%
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Active 0 0%
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Incident 0 0%
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Incident 0 0%
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Commission Statments
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Dial Ask Quote Sold App Written Entitled
Monthly Quarterly Annually All

Charts

  1. 20 Day Challenge
  2. Success Rate (Cumulative)
  3. Pay Per Activity (Cumulative)
  4. Success Rate (Daily)
  5. Activity To Results
  6. Gravity Status
  7. Production By Source
  8. Quotes By Call Type
  9. Entitled/Written Comparison

Tables

  1. Activity & Production
  2. Pay By Month
  3. Cancelled Policies
  4. Cumulative Activity
  5. Renewal Projection
  6. Production By Call Type
  7. Production By Source
  8. Carrier Production
  9. Quote to Close By Type
  10. Money Management
  11. Taxes
Call Type

Team Member

Start Date
Call TypeTeam Member

To Do Complete Log

CompletedOpen
Set Goals
User Account Div
Content Div

Programming To-Do List

Name To-Do Goal Date Action

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