<% ' FP_ASP ASP Automatically generated by a Frontpage Component. Do not Edit. On Error Resume Next Session("FP_OldCodePage") = Session.CodePage Session("FP_OldLCID") = Session.LCID Session.CodePage = 1252 Session.LCID = 1033 Err.Clear strErrorUrl = "" If Request.ServerVariables("REQUEST_METHOD") = "POST" Then If Request.Form("VTI-GROUP") = "0" Then Err.Clear Set fp_conn = Server.CreateObject("ADODB.Connection") FP_DumpError strErrorUrl, "Cannot create connection" Set fp_rs = Server.CreateObject("ADODB.Recordset") FP_DumpError strErrorUrl, "Cannot create record set" fp_conn.Open Application("Contact information and feedback_ConnectionString") FP_DumpError strErrorUrl, "Cannot open database" fp_rs.Open "Results", fp_conn, 1, 3, 2 ' adOpenKeySet, adLockOptimistic, adCmdTable FP_DumpError strErrorUrl, "Cannot open record set" fp_rs.AddNew FP_DumpError strErrorUrl, "Cannot add new record set to the database" Dim arFormFields0(60) Dim arFormDBFields0(60) Dim arFormValues0(60) arFormFields0(0) = "A_financial_analysis" arFormDBFields0(0) = "A_financial_analysis" arFormValues0(0) = Request("A_financial_analysis") arFormFields0(1) = "Critical_illness_insurance" arFormDBFields0(1) = "Critical_illness_insurance" arFormValues0(1) = Request("Critical_illness_insurance") arFormFields0(2) = "Business_Overhead_Expense_Protection" arFormDBFields0(2) = "Business_Overhead_Expense_Protection" arFormValues0(2) = Request("Business_Overhead_Expense_Protection") arFormFields0(3) = "Your_WorkPhone" arFormDBFields0(3) = "Your_WorkPhone" arFormValues0(3) = Request("Your_WorkPhone") arFormFields0(4) = "How_to_pay_my_Estate_“taxes”" arFormDBFields0(4) = "How_to_pay_my_Estate_“taxes”" arFormValues0(4) = Request("How_to_pay_my_Estate_“taxes”") arFormFields0(5) = "Auto_insurance_review" arFormDBFields0(5) = "Auto_insurance_review" arFormValues0(5) = Request("Auto_insurance_review") arFormFields0(6) = "Auto_Insurance_renewal_date" arFormDBFields0(6) = "Auto_Insurance_renewal_date" arFormValues0(6) = Request("Auto_Insurance_renewal_date") arFormFields0(7) = "Business_loan_insurance" arFormDBFields0(7) = "Business_loan_insurance" arFormValues0(7) = Request("Business_loan_insurance") arFormFields0(8) = "Portfolio_Evaluation" arFormDBFields0(8) = "Portfolio_Evaluation" arFormValues0(8) = Request("Portfolio_Evaluation") arFormFields0(9) = "Buy_Sell_Plans" arFormDBFields0(9) = "Buy_Sell_Plans" arFormValues0(9) = Request("Buy_Sell_Plans") arFormFields0(10) = "Executive_bonus_plans" arFormDBFields0(10) = "Executive_bonus_plans" arFormValues0(10) = Request("Executive_bonus_plans") arFormFields0(11) = "Estate_maximization" arFormDBFields0(11) = "Estate_maximization" arFormValues0(11) = Request("Estate_maximization") arFormFields0(12) = "Ways_to_protect_my_families_lifestyle" arFormDBFields0(12) = "Ways_to_protect_my_families_lifestyle" arFormValues0(12) = Request("Ways_to_protect_my_families_lifestyle") arFormFields0(13) = "Converting_temporary_insurance" arFormDBFields0(13) = "Converting_temporary_insurance" arFormValues0(13) = Request("Converting_temporary_insurance") arFormFields0(14) = "Ways_to_protect_my_income_in_the_event_of_sickness_or_accident" arFormDBFields0(14) = "Ways_to_protect_my_income_in_the_event_of_sickness_or_accident" arFormValues0(14) = Request("Ways_to_protect_my_income_in_the_event_of_sickness_or_accident") arFormFields0(15) = "Group_insurance_renewal_date" arFormDBFields0(15) = "Group_insurance_renewal_date" arFormValues0(15) = Request("Group_insurance_renewal_date") arFormFields0(16) = "Interested_in_discussing" arFormDBFields0(16) = "Interested_in_discussing1" arFormValues0(16) = Request("Interested_in_discussing") arFormFields0(17) = "Your_StreetAddress" arFormDBFields0(17) = "Your_StreetAddress" arFormValues0(17) = Request("Your_StreetAddress") arFormFields0(18) = "Your_HomePhone" arFormDBFields0(18) = "Your_HomePhone" arFormValues0(18) = Request("Your_HomePhone") arFormFields0(19) = "Interested_in" arFormDBFields0(19) = "Interested_in" arFormValues0(19) = Request("Interested_in") arFormFields0(20) = "Tax_favoured_investments_annuities" arFormDBFields0(20) = "Tax_favoured_investments_annuities" arFormValues0(20) = Request("Tax_favoured_investments_annuities") arFormFields0(21) = "Commercial_insurance_review" arFormDBFields0(21) = "Commercial_insurance_review" arFormValues0(21) = Request("Commercial_insurance_review") arFormFields0(22) = "Business_Property_casualty_date" arFormDBFields0(22) = "Business_Property_casualty_date" arFormValues0(22) = Request("Business_Property_casualty_date") arFormFields0(23) = "Your_Organization" arFormDBFields0(23) = "Your_Organization" arFormValues0(23) = Request("Your_Organization") arFormFields0(24) = "Your_Province" arFormDBFields0(24) = "Your_Province" arFormValues0(24) = Request("Your_Province") arFormFields0(25) = "Your_PostalCode" arFormDBFields0(25) = "Your_PostalCode" arFormValues0(25) = Request("Your_PostalCode") arFormFields0(26) = "My_Risk_profile_and_my_current_portfolio" arFormDBFields0(26) = "My_Risk_profile_and_my_current_portfolio" arFormValues0(26) = Request("My_Risk_profile_and_my_current_portfolio") arFormFields0(27) = "Business_Life_Insurance" arFormDBFields0(27) = "Business_Life_Insurance" arFormValues0(27) = Request("Business_Life_Insurance") arFormFields0(28) = "Business_Insurance_best_value_review_property_casualty" arFormDBFields0(28) = "Business_Insurance_best_value_review_property_casualty" arFormValues0(28) = Request("Business_Insurance_best_value_review_property_casualty") arFormFields0(29) = "Your_Address2" arFormDBFields0(29) = "Your_Address2" arFormValues0(29) = Request("Your_Address2") arFormFields0(30) = "Business_Succession_Planning" arFormDBFields0(30) = "Business_Succession_Planning" arFormValues0(30) = Request("Business_Succession_Planning") arFormFields0(31) = "Your_Title" arFormDBFields0(31) = "Your_Title" arFormValues0(31) = Request("Your_Title") arFormFields0(32) = "Planning_for_retirement" arFormDBFields0(32) = "Planning_for_retirement" arFormValues0(32) = Request("Planning_for_retirement") arFormFields0(33) = "Mortgage_Date" arFormDBFields0(33) = "Mortgage_Date" arFormValues0(33) = Request("Mortgage_Date") arFormFields0(34) = "Diversification_Modern_Portfolio_Theory" arFormDBFields0(34) = "Diversification_Modern_Portfolio_Theory" arFormValues0(34) = Request("Diversification_Modern_Portfolio_Theory") arFormFields0(35) = "Personal_Health_Insurance" arFormDBFields0(35) = "Personal_Health_Insurance" arFormValues0(35) = Request("Personal_Health_Insurance") arFormFields0(36) = "Mortgage_renewal" arFormDBFields0(36) = "Mortgage_renewal" arFormValues0(36) = Request("Mortgage_renewal") arFormFields0(37) = "Long_Term_Care_Coverage" arFormDBFields0(37) = "Long_Term_Care_Coverage" arFormValues0(37) = Request("Long_Term_Care_Coverage") arFormFields0(38) = "Nursing_Home_Asset_Protection" arFormDBFields0(38) = "Nursing_Home_Asset_Protection" arFormValues0(38) = Request("Nursing_Home_Asset_Protection") arFormFields0(39) = "Mortgage_protection_insurance" arFormDBFields0(39) = "Mortgage_protection_insurance" arFormValues0(39) = Request("Mortgage_protection_insurance") arFormFields0(40) = "Insurance_on_my_spouse" arFormDBFields0(40) = "Insurance_on_my_spouse" arFormValues0(40) = Request("Insurance_on_my_spouse") arFormFields0(41) = "Other" arFormDBFields0(41) = "Other2" arFormValues0(41) = Request("Other") arFormFields0(42) = "Key_Employee_Insurance" arFormDBFields0(42) = "Key_Employee_Insurance" arFormValues0(42) = Request("Key_Employee_Insurance") arFormFields0(43) = "Pension_profit_sharing" arFormDBFields0(43) = "Pension_profit_sharing" arFormValues0(43) = Request("Pension_profit_sharing") arFormFields0(44) = "Group_Insurance" arFormDBFields0(44) = "Group_Insurance" arFormValues0(44) = Request("Group_Insurance") arFormFields0(45) = "Your_FullName" arFormDBFields0(45) = "Your_FullName" arFormValues0(45) = Request("Your_FullName") arFormFields0(46) = "Your_City" arFormDBFields0(46) = "Your_City" arFormValues0(46) = Request("Your_City") arFormFields0(47) = "Home_insurance_review" arFormDBFields0(47) = "Home_insurance_review" arFormValues0(47) = Request("Home_insurance_review") arFormFields0(48) = "Shareholder_benefits" arFormDBFields0(48) = "Shareholder_benefits" arFormValues0(48) = Request("Shareholder_benefits") arFormFields0(49) = "Executive_compensation" arFormDBFields0(49) = "Executive_compensation" arFormValues0(49) = Request("Executive_compensation") arFormFields0(50) = "Pension_maximization" arFormDBFields0(50) = "Pension_maximization" arFormValues0(50) = Request("Pension_maximization") arFormFields0(51) = "Insurance_on_myself" arFormDBFields0(51) = "Insurance_on_myself" arFormValues0(51) = Request("Insurance_on_myself") arFormFields0(52) = "Existing_policy_plan_review" arFormDBFields0(52) = "Existing_policy_plan_review" arFormValues0(52) = Request("Existing_policy_plan_review") arFormFields0(53) = "Insurance_on_my_children_grandchildren" arFormDBFields0(53) = "Insurance_on_my_children_grandchildren" arFormValues0(53) = Request("Insurance_on_my_children_grandchildren") arFormFields0(54) = "Home_insurance_renewal_date" arFormDBFields0(54) = "Home_insurance_renewal_date" arFormValues0(54) = Request("Home_insurance_renewal_date") arFormFields0(55) = "Your_Email" arFormDBFields0(55) = "Your_Email" arFormValues0(55) = Request("Your_Email") arFormFields0(56) = "Comments_and_Questions" arFormDBFields0(56) = "Comments_and_Questions" arFormValues0(56) = Request("Comments_and_Questions") arFormFields0(57) = "Enhanced_Lifestyle_Plan" arFormDBFields0(57) = "Enhanced_Lifestyle_Plan" arFormValues0(57) = Request("Enhanced_Lifestyle_Plan") arFormFields0(58) = "Asset_management" arFormDBFields0(58) = "Asset_management" arFormValues0(58) = Request("Asset_management") arFormFields0(59) = "Commercial_insurance_renewal_date" arFormDBFields0(59) = "Commercial_insurance_renewal_date" arFormValues0(59) = Request("Commercial_insurance_renewal_date") FP_SaveFormFields fp_rs, arFormFields0, arFormDBFields0 If Request.ServerVariables("REMOTE_HOST") <> "" Then FP_SaveFieldToDB fp_rs, Request.ServerVariables("REMOTE_HOST"), "Remote_computer_name" End If If Request.ServerVariables("HTTP_USER_AGENT") <> "" Then FP_SaveFieldToDB fp_rs, Request.ServerVariables("HTTP_USER_AGENT"), "Browser_type" End If FP_SaveFieldToDB fp_rs, Now, "Timestamp" If Request.ServerVariables("REMOTE_USER") <> "" Then FP_SaveFieldToDB fp_rs, Request.ServerVariables("REMOTE_USER"), "User_name" End If fp_rs.Update FP_DumpError strErrorUrl, "Cannot update the database" fp_rs.Close fp_conn.Close FP_FormConfirmation "text/html; charset=windows-1252",_ "Form Confirmation",_ "Thank you for submitting the following information:",_ "Contact%20information%20and%20feedback.htm",_ "Return to the form." End If End If Session.CodePage = Session("FP_OldCodePage") Session.LCID = Session("FP_OldLCID") %> Contact information and feedback form

Contact information and feedback

If you would like more information or if you would like to arrange a no obligation initial interview you can:

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Call toll-free at 1-888-205-7011 ext. 261 in Halifax call (902) 422-1631 ext. 261

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Email us at paul.wilson@freedom55financial.com

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Or if you prefer print and mail or fax the form below

We are licensed in Nova Scotia only, inquiries from other provinces will be referred to practitioners who are licensed in your province.

        Please provide the following contact information:      

   
Name  
Title
Organization
Street Address
Address (cont.)
City
Province
Postal Code
Work Phone
Home Phone
E-mail
   

Comments or Questions

 

You set the Priorities

  

Please check all items you are interested in discussing.

  

 Enhanced Lifestyle Plan

Long Term Care Insurance
 A financial analysis "Nursing Home Asset Protection"

Tax-favoured investments /annuities

  My Risk profile and my current portfolio
 Estate maximization  Asset management
How to pay my Estate “taxes”  Portfolio Evaluation
 Ways to protect my families lifestyle  Diversification (Modern Portfolio Theory)
 Mortgage protection insurance Planning for retirement
Personal Health Insurance Pension maximization
 Insurance on myself Existing policy / plan review
Insurance on my spouse Auto insurance review   renewal date 
Insurance on my children / grandchildren Home insurance review  renewal date 
Converting temporary insurance Commercial insurance review date 
Critical Illness Insurance Mortgage renewal-  date  
 Ways to protect my income in the event of sickness or accident   Other

Business Owners only

  

Please check off any items of interest or concern.

  
  Business Succession Planning   Shareholder benefits
  Buy / Sell Plans   Business Overhead Expense Protection
  Key Employee Insurance   Business loan insurance
  Pension / profit sharing  Group Insurance renewal date     
  Executive compensation   Business Life Insurance
 Executive bonus plans  Business Insurance (best value?) review  property & casualty renewal date  
 Other  Other IPP's,etc.
           

 

 

J. Paul Wilson, CFP, CLU, CH.F.C., TEP

Suite 1600, Purdy’s Wharf Tower 1, Halifax, Nova Scotia, B3J 3N2

(902) 422- 1631 ext. 261 or 1-888-205-7011 ext. 261

Fax: (902) 422-3493

paul.wilson@freedom55financial.com

       

™ Trade-mark of The Financial Advisors Association of Canada carrying on business as Advocis

(CFP Flame logo)™ Certified Financial Planner™ and CFP™ are certification marks awarded by Financial Planners Standards Council under a license agreement with the CFP Board of Standards, Inc.

 

Copyright J. Paul Wilson 2003-2009