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Fast-Track PageDustin Neathery2020-09-16T09:39:06-05:00

Become our client! Complete the form at the bottom of this video. Once the form is completed, one of our awesome team members will reach out to you.

Who is James Neathery?

James has 28+ years of experience in the financial services industry and has been practicing the Infinite Banking Concept for 15+ years.

Fill Out The Fast-Track Form

Fill out the form carefully and make sure all information is correct. If you experience any issues, email us at myteam@bankingwithlife.com.

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Let's get started!

Name *

First

Last

Phone *

Email: *

Birthday *//

Are you a U.S. citizen? *

Yes
No

What is your status?

Marital Status *

Married
Single
Separated
Divorced
Domestic Partnership

Spouse's Name:

Spouse's Phone:

Spouse's Email:

Spouse's Birthday//

Street Address: *

City: *

State: *

Zip Code: *

Are you starting a policy on your spouse too?

Yes
No

Do you have children? *

Yes
No

Children's ages:

Financials

Primary Residence *

(Renters indicate monthly rent amount)

Balance Owed:

(Not applicable for renters)

Do you own investment properties? *

Yes
No

How many investment properties do you own?

1
2
3
4
5
6+

You will only need information for up to '5' investment properties.

Property 1

Is it commercial or residential property?

Commercial
Residential

Value of property

Property balance

Annual property gross cash flow

Property 2

Is it commercial or residential property?

Commercial
Residential

Value of property

Property balance

Annual property gross cash flow

Property 3

Is it commercial or residential property?

Commercial
Residential

Value of property

Property balance

Annual property gross cash flow

Property 4

Is it commercial or residential property?

Commercial
Residential

Value of property

Property balance

Annual property gross cash flow

Property 5

Is it commercial or residential property?

Commercial
Residential

Value of property

Property balance

Annual property gross cash flow

Do you save 10% or more? *

Yes
No

Are you employed or retired? *

Employed
Retired

Employer *

If you are retired, put your former employer.

Occupation *

If you are retired, put your former occupation.

Annual Income *

2020's Income Estimated*

Annual Income 2019: *

2019's Income

Spouse's Employer

Spouse's Occupation

Spouse's Annual Income

2020's Income Estimated

Spouse's Annual Income 2019:

2019's Income

Assets

Cash on hand *

Select the assets you have (Select all that apply)

401k
IRA
403b
Annuity
Stocks
Bonds
TSP Plan
Pension Plan
Mutual Funds
Money Market Accounts
C.D.s
ROTH IRA
TSA Pension
529 Plan
Other Assets

(Fill in the amounts below)

401k:

401k

IRA:

IRA

403b:

403b

Annuity:

Annuity

Stocks:

Stocks

Bonds:

Bonds

TSP Plan:

TSP Plan

Pension Plan:

Pension Plan

Mutual Funds:

Mutual Funds

Money Market Accounts:

Money Market Accounts

C.D.s:

C.D.s

ROTH IRA:

ROTH IRA

TSA Pension:

TSA Pension

529 Plan:

529 Plan

Other Assets:

(Please explain the asset)

Select the assets your spouse has (Select all that apply)

401k
IRA
403b
Annuity
Stocks
Bonds
TSP Plan
Pension Plan
Mutual Funds
Money Market Accounts
C.D.s
ROTH IRA
TSA Pension
Other Assets

(Fill in the amounts below)

401k (Spouse):

401k

IRA (Spouse):

IRA

403b (Spouse):

403b

Annuity (Spouse):

Annuity

Stocks (Spouse):

Stocks

Bonds (Spouse):

Bonds

TSP Plan (Spouse):

TSP Plan

Pension Plan (Spouse):

Pension Plan

Mutual Funds (Spouse):

Mutual Funds

Money Market Accounts (Spouse):

Money Market Accounts

C.D.s (Spouse):

C.D.s

ROTH IRA (Spouse):

ROTH IRA

TSA Pension (Spouse):

TSA Pension

Other Assets (Spouse):

(Please explain the asset)

Liabilities *

Student Loans
Credit Card Debt
Auto Loan Balance
Other
None

(Select all that apply)

Student Loans:

Student Loans

Credit Card Debt:

Credit Card Debt

Auto Loans:

Auto Loan Balance

Please describe your other liabilities

Other Liability 1 (please describe)

Other (please describe) 2:

Other Liability 2 (please describe)

Other (please describe) 3:

Other Liability 3 (please describe)

Spouse's Liabilities *

Student Loans
Credit Card Debt
Auto Loan Balance
Other
None

(Select all that apply)

Student Loans (Spouse):

Student Loans

Credit Card Debt (Spouse):

Credit Card Debt

Auto Loans (Spouse):

Auto Loan Balance

Please describe your spouse's other liabilities

Other Liability 1 (please describe)

Other Liability 2 (Spouse):

Other Liability 2 (please describe)

Other Liability 3 (please describe) (Spouse):

Other Liability 3 (please describe)

Have you ever filed bankruptcy? *

Yes
No

What chapter?

What is the discharge date?

Policy Information

Desired use for your new policy: *

Capital Accumulation
Retirement Income
Real Estate Investing
Debt Elimination
Legacy Building
Other

Goals: *

(What are you trying to achieve by using the Infinite Banking Concept®?)

Timeline to start your policy? *

ASAP
1 Month
2 Months
3 Months(+)
TBD

How much premium would you like to pay? *

Would you like to pay monthly or annually? *

Monthly
Annually
TBD

Who is the beneficiary?

Timeline to start spouse's policy?

ASAP
1 Month
2 Months
3 Month(+)
TBD

How much premium would your spouse like to pay?

Will spouse pay monthly or annually?

Monthly
Annually
TBD

Do you have life insurance? *

Term Life Insurance
Whole Life Insurance
Universal Life Insurance
Variable Life Insurance
None of the above

(Fill in the amounts below)

Term Life Insurance:

Term Life Insurance

Whole Life Insurance:

Whole Life Insurance

Universal Life Insurance:

Universal Life Insurance

Variable Life Insurance:

Variable Life Insurance

Does your spouse have life insurance?

Term Life Insurance
Whole Life Insurance
Universal Life Insurance
Variable Life Insurance
None of the above

(Fill in the amounts below)

Term Life Insurance (Spouse):

Term Life Insurance

Whole Life Insurance (Spouse):

Whole Life Insurance

Universal Life Insurance (Spouse):

Universal Life Insurance

Variable Life Insurance (Spouse):

Variable Life Insurance

Medical Information

Primary Physician: *

Put "N/A" if you do not have a primary physician or do not have this information.

Primary Physician Address: *

Put "N/A" if you do not have a primary physician or do not have this information.

Phone:

Skip this if you entered "N/A" above.

Does spouse have the same physician?

Yes
No

Spouse's Primary Physician:

Put "N/A" if your spouse does not have a primary physician or does not have this information.

Spouse's Primary Physician Address:

Put "N/A" if your spouse does not have a primary physician or does not have this information.

Spouse'sPhone:

Skip this if you entered "N/A" above.

This is not an application. However, once the application is started we will need the past 5 years of doctors appointments and check-ups, past 10 years of significant medical diagnoses, problems, treatments or surgeries, etc. with dates and all attending physicians' information. If there are any major surgeries, complications, or unfulfilled doctor referrals, your medical records may be required later.

Have you ever used nicotine? *

Yes
No

This includes ANY nicotine product. (Cigarettes, Snus, Dip/Snuff, Cigars, Pipe Tobacco, Cigarillos, Inhalers, Patches, Gum, Lozenges, E-Cigarettes/Vapes of all types, Hookah, etc.)

When was the last time you used nicotine and in what form?

Has spouse ever used nicotine?

Yes
No

This includes ANY nicotine product. (Cigarettes, Snus, Dip/Snuff, Cigars, Pipe Tobacco, Cigarillos, Inhalers, Patches, Gum, Lozenges, E-Cigarettes/Vapes of all types, Hookah, etc.)

When was the last time spouse used nicotine and in what form?

Do you have travel outside of the U.S. or Canada scheduled in the next two years? *

If yes, all locations and dates required.

Does spouse have travel outside of the U.S. or Canada scheduled in the next two years?

If yes, all locations and dates required.

File Uploads (Uploading these items will expedite the process significantly)

Since you're adding your spouse, we will also need their driver's license! Use the same box below to upload both of your driver's licenses.

Please upload your Driver's License or State ID here. - This is necessary to complete our process!

Click or drag a file to this area to upload.

We only need the front of the license/ID.

If you would like us to review any illustrations and/or have medical documentation, please upload it here. - THIS IS OPTIONAL

Click or drag files to this area to upload. You can upload up to 15 files.

As stated earlier, medical records could reduce underwriting time by as much as 30 days.

Just a few more things!

Please choose from the drop-down menu how you heard about us. *

How many podcasts have you watched/listened to?

1-5
6-10
10+

How many of our YouTube videos have you watched?

1-5
6-10
10+

Please tell us who referred you. We'd like to thank them!

You selected "Other." Please tell us how you heard about us.

Have you read R. Nelson Nash's "Becoming Your Own Banker?" *

Yes
In the process
No

Have you watched our "Becoming Your Own Banker Book Review?" *

Yes
No

Do you own one or more IBC® policies? *

Yes
No

Last question! Are you a licensed Life Insurance Agent or Advisor? *

Yes
No

Today's Date *//

Please do not make any changes to current policies or accounts prior to chatting with one of our team members.

Message

“*” Means Required

Success Stories:

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When you Fast-Track:

You will receive a call from one of our awesome team members to assist you.

Receive expedited service:

When you fill out the Fast-Track form you will have access to client only content:

Client Only Live-streamed Q&As with James
Multiple In-depth Infinite Banking Modules
Private Infinite Banking Seminar Recordings

Important Note:

Our schedule is full of people just like you, becoming their own banker… So fill out the Fast-Track form below ASAP to get started.

Our Commitment:

Is to provide the best service possible and the best financial solutions for our clients while keeping your information strictly confidential.

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Disclosures

Investment advisory services offered through Redhawk Wealth Advisors, Inc., and SEC Registered Investment Advisor. James Neathery & Associates are not affiliated.

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