Close
Log In
Already a member?
Log in in here
Request Website Access
Name
*
First
Last
Email
*
Are you associated with an agency or corporation?
*
No, I am independent
Yes (Please list your agency below)
Agency/Corporate Name
How did you hear about Beacon Financial?
800-440-5460 / 801-397-3030
AGENT LOGIN
top menu
Skip to primary content
Skip to secondary content
Home
Annuities
Life
Learning Center
Incentives
About Beacon
Illustration Form
Life Illustrations
Fields marked with * are required.
Date Needed
*
Agent Name
*
Email
*
Daytime Phone
*
Illustration Data
Client Name
DOB
Sex
- Please Select -
Male
Female
Spouse Name
DOB
Sex
- Please Select -
Male
Female
Company(ies)
Insured No. 1 Rating
Best Available
Preferred
Standard
No Tobacco
Tobacco
other Tobacco
Insured No. 2 Rating
Best Available
Preferred
Standard
No Tobacco
Tobacco
other Tobacco
State
- Please Select -
Second Choice
Third Choice
Objective
Product
Survivorship
UL
Whole Life
EIUL
Term 10
Term 15
Term 20
Term 30
ROP Term 15
ROP Term 15
ROP Term 30
Death Benefit
Desired Premium
If 1035 Exchange, Rollover Amount
Show Income at Age:
Illustrate for No. of Years
Impaired Risk?
- Please Select -
YES
NO
Comments
