Business Owner SLIRP Sale
Questionnaire (BOSS)
Agent
Name and Designations:
Agent Code:
Approved address:
Approved Phone #: _ Approved email:
CA/AR Insurance License #
(
If applicable
)
Business
and
Business
Owner
Name of the Business: _____________________________________________
Name of Insured Business Owner: Gender
Insured’s
Date
of
Birth:
Underwriting
Classification:_____________ State of Issue:___
Policy
Illustration
Information
Type of Policy to Illustrate (usually
CWL):
Annual
Premium to Illustrate:
$
Number
of Years to Pay Premium: _
Do you want to illustrate a One-Time loan into a PDA Account? Yes
or
No
Age at which would you like
to see distributions begin
Number of years to show distributions:
Current Business Cash Reserves:
Interest Rate Earned on Busines Cash Reserves: _________________ Income Tax Rate ____%
INTERNAL USE ONLY. This
material is to be completed with information and assumptions provided by the client. New York Life Insurance
Company, its agents or employees may not give legal, tax or accounting advice. Individuals should consult their own professional advisors
before implementing any planning strategies. © 2019 New York Life Insurance Company. All rights reserved. SMRU 1801742 (exp. 8.31.2022)
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