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Contact Information
First Name : 
Last Name : 
Phone : 
Email Address : 
 
 
 
Gender 
 
Male
 
Female 
 
 
 
* What is Your Current Age ?
 
Below 18 
 
18-25
 
25-35
 
35-45
 
Above 45
 
 
 
* Occupation ?
 
Student 
 
Employee
 
Business
 
Others
 
 
 
Yearly Income ?
 
Below 1Lakh
 
1Lakh-5Lakhs
 
5Lakhs-10Lakhs
 
Above 10Lakhs
 
 
 
*  Which among the following would you consider is the best investment options ?
 
Fixed Deposit
 
Real Estate
 
Gold
 
Mutual Funds
 
Others

 
 
 
 Are you happy with your Insurance policy?
 
Yes
 
No
 
 
 
* What financial constraints guided you to opt for Investing in Insurance ? 
 
Returns and dividends
 
Lesser risk
 
Higher return at the end of maturity
 
Others 

 
 
 
* What is your financial goal
 
Inome generation
 
Capital appreciation and income generation
 
Capital preservation
 
Others
 
 
 
* What you will do with the amount you receive from insurance policy ?
 
Re – invest
 
 Spend as financial expenditure
 
Others, then please mention along with answer