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ANNUITY QUOTE REQUEST FORM:

This Annuity Quote Request Form is designed to gather information from prospective policy owner(s) to determine whether the purchase of an annuity is suitable to meet one's financial needs and objectives.  All information collected is confidential and held private; the information gathered is for the purposes of generating an annuity quote/illustration at your request.  Your personal information will not be sold to any person nor to any company for any reason. 

In addition, this questionnaire will take approximately 3-5 minutes to complete.  All the fields that have an (*) asterisk behind it are mandatory to complete thus, any mandatory fields left unanswered will prohibit this quote request form from being submitted.  Any questions or concerns just email: insureyourvision@evbsinsurance.agency.   

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By your clicking the "Request A Consultation" button above and submitting your online annuity quote request form to (EVBS) Insurance Agency, Inc., you are agreeing by your electronic signature to give (EVBS) Insurance Agency, Inc. your prior express written consent and continuing established business relationship permission to contact you at each the cell, the work phone number and/or the email address(s) you provided in your online quote request.  Furthermore, you have in written consent from your electronic signature given (EVBS) Insurance Agency, Inc. permission to contact you by each phone and/or through each  email message(s) as the user any time from and any time after your inquiry for purposes of all federal and state telemarketing and Do-Not-Call laws because you were affirmative in providing this information through your online quote request,   For all intentions, (EVBS) Insurance Agency, Inc. will market our products and services to you and your consent is not required to get a quote nor purchase anything from (EVBS) Insurance Agency, Inc. At your discretion, you may instead decline your quote request by reaching out to us by phone at 1-888-519-3330 @ Ext.1 or by email: insureyourvision@evbsinsurance.agency.

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