Form 1191

, I am considering the potential of working in the business and professional markets. To help make my decision, I am doing a survey with a sample of businessowners, executives and professionals like yourself to understand the attitudes and feelings of business people toward planning ideas, and to learn the reasons why certain financial products and services may be more attractive than others. Can you give me about 15 minutes to review some questions with you? The answers you share will be a big help to me. Of course, our discussion will be completely confidential.

   1. Basic Information
 
Name of business person:

Title:

Name of business:

Business address:

Type of business:

Are you married? Yes               No

Do you have any children? Yes               No

How is your business structured?

Corporation
Partnership
Sole Proprietorship
Sub S Corporation
Limited Liability
     Corporation (LLC)

How many owners are there?

How many employees do you have?

(Continued)

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Ohio National is not affiliated with, nor does it endorse or sponsor, any particular prospecting, marketing or selling system.

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