Below is a sample containing the data fields that we attempt to capture and any leads you purchase at agedleadstore.com will always be in same column arrangement which is similar to or exactly the below. Each of our vendor's forms have different fields and info each consumer opts to fill in varies but you will always receive at least the required fields below indicated by an asterisk. The leads will be retrievable upon purchase in the orders area in a .csv format that will open right up into an Excel Spreadsheet if you have Excel on your computer. You should be able to print 30-50 leads per excel spreadsheet page depending on font size you select.
| Contact Information | |
| Date/Time*: | 1/1/2012 12:20 |
| Applicant Name*: | John Doe |
| Street Address*: | 1234 Main St. |
| City*: | Los Angeles |
| Zip Code*: | 90016 |
| Phone Number*: | (310) 555-1212 |
| Alternate Phone Number: | (310) 555-1213 |
| Cell Phone Number: | (310) 555-1214 |
| Email Address*: | john@example.com |
| IP Address: | 127.0.0.1 |
| Policy Information | |
| Currently Insured: | Yes |
| Current Carrier: | State Farm |
| Length with Company: | 10 Years |
| Policy Expires: | 1/1/2012 |
| Coverage: | Superior |
| Number of Cars: | 2 |
| Number of Drivers: | 2 |
| Bodily Injury Insurance: | Yes |
| Uninsured Motorist Insurance: | Yes |
| Property Damage Insurance: | Yes |
| Liability Limits: | $100,000/$300,000/$100,000 |
| Credit History: | Excellent |
| Bankruptcy: | No |
| Homeowner: | Yes |
| Length at Residence: | 5 Years |
| Length Employed: | 5 Years |
| Medical Payments: | No |
| Driver Information | |
| Driver 1 Name: | John Doe |
| Driver 1 Date of Birth*: | 1/1/1970 |
| Driver 1 DUI: | No |
| Driver 1 DUI Date: | N/A |
| Driver 1 Education: | College |
| Driver 1 Gender: | Male |
| Driver 1 GPA: | N/A |
| Driver 1 License Number: | I1234568 |
| Driver 1 License State: | CA |
| Driver 1 License Status: | Valid |
| Driver 1 Marital Status: | Married |
| Driver 1 Occupation: | Manager |
| Driver 1 Relation: | Primary |
| Driver 1 SR-22: | No |
| Driver 1 Suspension: | No |
| Driver 1 Driving School: | Yes |
| Driver 1 Age Got License: | 16 |
| Driver 1 Military: | No |
| Driver 1 Student: | No |
| Driver 1 Violations: | No |
| Driver 1 Violation 1 Type: | N/A |
| Driver 1 Violation 1 Year: | N/A |
| Driver 1 Violation 2 Type: | N/A |
| Driver 1 Violation 2 Year: | N/A |
| Driver 1 Violation 3 Type: | N/A |
| Driver 1 Violation 3 Year: | N/A |
| Driver 2 Name: | Jane Doe |
| Driver 2 Date of Birth: | 1/1/1970 |
| Driver 2 DUI: | No |
| Driver 2 DUI Date: | N/A |
| Driver 2 Education: | College |
| Driver 2 Gender: | Female |
| Driver 2 GPA: | N/A |
| Driver 2 License Number: | I1234569 |
| Driver 2 License State: | CA |
| Driver 2 License Status: | Valid |
| Driver 2 Marital Status: | Married |
| Driver 2 Occupation: | Account Director |
| Driver 2 Relation: | Spouse |
| Driver 2 SR-22: | No |
| Driver 2 Suspension: | No |
| Driver 2 Driving School: | No |
| Driver 2 Age Got License: | 16 |
| Driver 2 Military: | No |
| Driver 2 Student: | No |
| Driver 2 Violations: | No |
| Driver 2 Violation 1 Type: | N/A |
| Driver 2 Violation 1 Year: | N/A |
| Driver 2 Violation 2 Type: | N/A |
| Driver 1 Violation 2 Year: | N/A |
| Driver 2 Violation 3 Type: | N/A |
| Driver 2 Violation 3 Year: | N/A |
| Driver 3 Name: | N/A |
| Driver 3 Date of Birth: | N/A |
| Driver 3 DUI: | N/A |
| Driver 3 DUI Date: | N/A |
| Driver 3 Education: | N/A |
| Driver 3 Gender: | N/A |
| Driver 3 GPA: | N/A |
| Driver 3 License Number: | N/A |
| Driver 3 License State: | N/A |
| Driver 3 License Status: | N/A |
| Driver 3 Marital Status: | N/A |
| Driver 3 Occupation: | N/A |
| Driver 3 Relation: | N/A |
| Driver 3 SR-22: | N/A |
| Driver 3 Suspension: | N/A |
| Driver 3 Driving School: | N/A |
| Driver 3 Age Got License: | N/A |
| Driver 3 Military: | N/A |
| Driver 3 Student: | N/A |
| Driver 3 Violations: | N/A |
| Driver 3 Violation 1 Type: | N/A |
| Driver 3 Violation 1 Year: | N/A |
| Driver 3 Violation 2 Type: | N/A |
| Driver 3 Violation 2 Year: | N/A |
| Driver 3 Violation 3 Type: | N/A |
| Driver 3 Violation 3 Year: | N/A |
| Vehicle Information | |
| Car 1 Make: | Mercedes Benz |
| Car 1 Model: | C250 |
| Car 1 Model Year: | 2010 |
| Car 1 Trim: | Silver |
| Car 1 Ownership: | Yes |
| Car 1 Annual Mileage: | 12,000 |
| Car 1 Daily Mileage: | 50 |
| Car 1 Total Mileage: | 10,000 |
| Car 1 Coverage: | Full |
| Car 1 Collision Deductible: | $500 |
| Car 1 Comprehensive Deductible: | $500 |
| Car 1 Commute Miles: | 50 |
| Car 1 Storage: | Private |
| Car 1 Salvaged: | No |
| Car 1 Main Use: | Work Commute |
| Car 1 Primary Driver: | John Doe |
| Car 1 Rental: | Yes |
| Car 1 Towing: | Yes |
| Car 1 Alarm: | Yes |
| Car 1 Anti-Lock Brakes: | Yes |
| Car 1 VIN: | WD123456789012345 |
| Car 1 Airbags: | Yes |
| Car 2 Make: | Mercedes Benz |
| Car 2 Model: | GLK350 |
| Car 2 Model Year: | 2010 |
| Car 2 Trim: | Black |
| Car 2 Ownership: | Yes |
| Car 2 Annual Mileage: | 10,000 |
| Car 2 Daily Mileage: | 30 |
| Car 2 Total Mileage: | 7,000 |
| Car 2 Coverage: | Full |
| Car 2 Collision Deductible: | $500 |
| Car 2 Comprehensive Deductible: | $500 |
| Car 2 Commute Miles: | 30 |
| Car 2 Storage: | Private |
| Car 2 Salvaged: | No |
| Car 2 Main Use: | Work Commute |
| Car 2 Primary Driver: | Jane Doe |
| Car 2 Rental: | Yes |
| Car 2 Towing: | Yes |
| Car 2 Alarm: | Yes |
| Car 2 Anti-Lock Brakes: | Yes |
| Car 2 VIN: | WD123456789012346 |
| Car 2 Airbags: | Yes |
| Car 3 Make: | N/A |
| Car 3 Model: | N/A |
| Car 3 Model Year: | N/A |
| Car 3 Trim: | N/A |
| Car 3 Ownership: | N/A |
| Car 3 Annual Mileage: | N/A |
| Car 3 Daily Mileage: | N/A |
| Car 3 Total Mileage: | N/A |
| Car 3 Coverage: | N/A |
| Car 3 Collision Deductible: | N/A |
| Car 3 Comprehensive Deductible: | N/A |
| Car 3 Commute Miles: | N/A |
| Car 3 Storage: | N/A |
| Car 3 Salvaged: | N/A |
| Car 3 Main Use: | N/A |
| Car 3 Primary Driver: | N/A |
| Car 3 Rental: | N/A |
| Car 3 Towing: | N/A |
| Car 3 Alarm: | N/A |
| Car 3 Anti-Lock Brakes: | N/A |
| Car 3 VIN: | N/A |
| Car 3 Airbags: | N/A |
| Claims Information | |
| Claim 1 Type: | Property Damage |
| Claim 1 Date: | 1/1/2005 |
| Claim 1 Amount: | $30,000 |
| Claim 2 Type: | N/A |
| Claim 2 Date: | N/A |
| Claim 2 Amount: | N/A |