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Consumer Profile Form

Please fill in the form below to request your quote and order form for a consumer lead list. The output format of the lead list will include the Name, Address, City, State and Zip code of your prospects. Phone Numbers are optionally included.
**Check the criteria below you are requesting.**
Phone numbers (if requesting phone numbers, SAN number must be entered above):

Estimate Age (check all ranges that apply):

Homeowner Type (check one if needed):

Marital Status (check one if needed):

Estimated Income (check all ranges that apply if needed):

Internet User (check one if needed):

Presence of Children (check one if needed):

Estimated Home Value (check all ranges that apply if needed):


AHIA Consumer List Program

AHIA will be offering mailing lists to agents upon request. Agents that would like to participate in the program will need to follow the steps to order below.

Steps for Ordering a Consumer List
  1. Fill out the Consumer Profile Form on the right and submit. You can also print the form here and fax to Joe Chetwood at 1-888-803-3537 or email to

  2. You will receive an email which will include the count and a quote for the price of the list. You will also receive an order form.

  3. Complete the order form and email or fax it back to Joe Chetwood.

  4. You will receive the consumer list in an Excel spreadsheet. This can be sent as soon as we receive the order form.


Pricing may vary from list to list. Pricing starts at $0.05 per name, but the average cost per name is $0.06. The more characteristics that are added, the more the list will cost. The minimum order amount is $35 per order; this includes a $5 bankruptcy data ommission fee and a $10 electronic output fee which consists of scrubbing the list against the FTC DO-NOT-CALL list.

Start by selecting geographic criteria:

  • Zip Code range
  • Individual zip code(s)
  • State
  • City
  • County
  • Area Code
  • Rooftop Radius from address

Then, Household Characteristics:

  • Estimated Age (FREE)
  • Homeowner Type (FREE)
  • Marital Status (FREE)
  • Estimated Income (FREE)
  • Exact Age ($0.05)
  • Presence of Children ($0.05)
  • Date of Birth ($0.05)
  • Internet User ($0.05)
  • Estimated Home Value ($0.05)
  • Ethnicity ($0.05)
  • Language Preference ($0.05)

***Specialty lists can be ordered as well. Any questions regarding more detailed information, please contact Jason Chetwood.

Example scenario: Agent Joe Smith is looking to do a burial insurance mail drop followed by a telemarketing campaign. He reviews the Consumer Profile Sheet and feels the best characteristics are the following:
  • Age 55-65
  • Within a 10 mile radius of Zip Code 78228
  • Estimated income of $35-$74K
  • Homeowner
  • Married couple
Cost analysis of this list:
  • 1506 names x $0.05 = $75.30
  • Estimated Age = $0
  • Estimated Income = $0
  • Homeowner - $0
  • Marital Status = $0
  • Bankruptcy Omit = $5.00
  • Electronic Output Fee = $10.00
  • Total Cost - $90.30/1506 = $0.059 per name