TARGETLEADS
 Lead Order Form

Sales Person's Name (if known)

Type of Mailer: 
Final Expense                  Medicare Supplement                Long-Term Care                 Combo lead            
Living Trust                    Annuity                                        Under Age Health 

 Mail Piece Code

Demographic Selections:   Or if you ran your own count, put your query # here

Age:  -            Income Range:             Omit PO Boxes?: Yes

Phones:  Only names with phones   All names with & without phones
Female Priority: Yes  No    Other:

(Please note that additional selects such as homeowners or females only are available but at an additional charge.)

 Zipcodes, SCF’s, and/or counties (list in order of preference from left to right):

 

*Number to mail:           @ $       per thousand = $          
*$50 setup applies to all orders under 1,000                                         

Duplicate List: hard copy ($25/M) email ($25/M)  
  3x5 cards ($45/M ) labels ($25/M)
Print phone # (where available) on lead card in reverse

$10/M

Street sequence on duplicate list

$3/M

Print month/year on duplicate list

$20/M

Select homeowners only

$10/M

Select by gender

$3/M

Questions?

Call our office at 800-723-5254 or email us at sales@targetleads.com.  One of our account executives would be more than happy to help you.

(Does not include any applicable shipping and handling.  Tax will apply to any TX order.)  

Notes/Special Instructions:

 

 Billing and/or Shipping Address:

Company:      
Name:
Address:
City:        
Zip:    
State:    
Phone #:      
Fax #:
Email:

Payment Method

*NOTE*  Our office will call you for your credit card information if you select to pay by credit card.  Order is subject to availability of zips under our 90 day file protection policy.

Please send confirmation of my order by: Fax    Email    **Confirmation of order is required

I have seen a sample of the mail piece.     Yes     No