Contact Us

Fasano Associates

1201 15th Street, N.W.
Suite 250
Washington D.C. 20005

Telephone: 202 457-8188, 202 457-1275
Facsimile: 202 457-8198

If you are contacting us to inquire about employment opportunities please include a resume and cover letter in your email.

To give us a more detailed description of your inquiry, please select the appropriate form below.

Fasano Associates' Disclosure Statement

Client Application

We are glad that you are interested in using our services. In order to expedite the process we would like your response to the following questions below. Upon evaluation and final approval, we will forward you our standard conditions and consulting agreement via e-mail for execution. On behalf of the entire team at Fasano Associates, Inc., thank you for your interest and we look forward to your reply.

Organizational Information

Legal Organization Name

Organization Type (LLC, Inc. ect)

Mailing Address

Address (Cont.)

City

State

Zip Code

Country

Website

Is your billing address the same as your mailing address? No Yes

Billing Address

Address (Cont.)

City

State

Country

Zip Code

Phone Number

Fax Number

Website

State of Incorporation or Organization

Which of the following characterizes your organization: Agency Broker Provider Funder Other

If you are an agency, which brokers are you dealing with?

If you are a broker or funder, which providers are you dealing with?

If other, please explain:

Are you currently getting life expectancy estimates from other firms? No Yes

Which firms?

What is your current monthly volume for life expectancy estimates?

What volume of life expectancy estimates would you expect to order from us?

Personnel Information

Name, title and email address of person authorized to execute agreements on behalf of applicant:

Full Name

Title

E-Mail Address

Name, title and email address of person designated to receive electronic LE reports:

Full Name

Title

E-Mail Address

Name, title and email address of accounts receivable contact:

Name

Title

E-Mail Address

How did you hear about Fasano Associates?