Submit a Case | WLP Wealth

Section 01

Your Information

Your Full Name

Your Email

Your Phone

Your Relationship to Client

Section 02

Client Information

Client First Name *

Client Last Name *

Client Email *

Client Phone *

Date of Birth *

State *

Gender (for underwriting purposes) *

Survivorship (Second-to-Die) Policy?

Section 03

Health Profile

Overall Health *

Tobacco / Nicotine Use (Last 5 Years) *

DUI / License Suspension (Last 5 Years) *

Any Known Medical Factors That May Materially Impact Life Insurance Underwriting? (optional)

Any Medications Taken Regularly? (optional)

For preliminary assessment only. Do not include medical records. Formal details will only be collected if the case proceeds to formal underwriting.

Section 04

Financial Profile

Annual Income (ballpark is fine) *

Net Worth (ballpark is fine) *

Liquid Assets (excl. retirement accounts) *

401k / IRA Contributions?

Estimated Credit Score Range *

Existing Life Insurance

Carrier + Face Amount (optional)

This is a preliminary assessment of structure and fit — not all cases will proceed to design.

Section 05

Capital Profile

Primary Profile Type *

Is this case personal or business-driven? *

Primary concern right now *

Where is the majority of capital currently held? *

Section 06

Case Goals

Main Objective *

Target Annual Tax-Advantaged Income

Target Retirement Age

Death Benefit Target

Open to bank-supported capital strategies? *

Additional Comments (optional)

Reviewed within 24–48 hours

Submit a Case
for Structural Review

Submission received.

Submit a Casefor Structural Review

Submission received.

Submit a Case
for Structural Review