Consumer
List Count Request Form
Please note that
all fields followed by an asterisk must be filled in.
First Name*
First Name*
Last Name*
Last Name*
E-mail Address*
E-mail Address*
Company Phone*
Company Phone*
Brief Description of
your Marketing Campaign?*
Brief Description of
your Marketing Campaign?*
Quantity Needed:*
Quantity Needed:*
Format
and Usage Options
Usage Type:*
Usage Type:*
Format Type:*
Format Type:*
Geographic
Selections
Targeted
State(s)
---Select---
All States
All States
& USA Territories
USA Territories
Northeastern States
Southeastern States
Northern Central
States
Southern Central
States
Western States
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Additional
State(s)
---Select---
All States
All States
& USA Territories
USA Territories
Northeastern States
Southeastern States
Northern Central
States
Southern Central
States
Western States
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Additional
State(s)
---Select---
All States
All States
& USA Territories
USA Territories
Northeastern States
Southeastern States
Northern Central
States
Southern Central
States
Western States
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Additional
State(s)
---Select---
All States
All States
& USA Territories
USA Territories
Northeastern States
Southeastern States
Northern Central
States
Southern Central
States
Western States
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Geography Selections:
ZIP4 Record
Type:
Geography Description:
Demographic
Selctions for List Customization
Adult Age
(2 year Increments):
Gender
(Individual):
Date of Birth:
Marital
Status:
Children's
Age Range (1 year):
Empty
Nester:
Ethnic Language Preference Codes:
Geo Match
Level Code:
Mail Order
Donor:
Mail
Responers:
Life
Insurance Policy Owner:
Political
Party -(Individual):
African
American Professional:
Small
Office-Home Office
Telephone
Number (Phone Flag):
Time Zone:
Travel/Vacation
Indicator:
Veteran:
Income and Credit Selections
Net Worth:
$0
$1 - $4,999
$5,000 - $9,999
$10,000 - $24,999
$25,000 - $49,999
$50,000 - $99,999
$100,000 - $249,999
$250,000 - $499,999
$500,000+
Uncoded/Null
Select All
Estimated
Income - Narrow Ranges:
Under $15,000
$15,000 - $19,999
$20,000 - $29,999
$30,000 - $39,999
$40,000 - $49,999
$50,000 - $59,999
$60,000 - $69,999
$70,000 - $79,999
$80,000 - $89,999
$90,000 - $99,999
$100,000 - $124,999
$125,000 - 149,999
$150,000 or More
Uncoded/Null
Select All
Range of
New Credit:
Expiration Date 1 (Loan Month):
Expiration Date 2 (Purchase Month)
Resident
and Property Selections
Homeowner/Renter:
Dwelling
Unit Size:
Home Market
Value:
$1,000 - $24,999
$25,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000 - $124,999
$125,000 - $149,999
$150,000 - $174,999
$175,000 - $199,999
$200,000 - $224,999
$225,000 - $249,999
$250,000 - $274,999
$275,000 - $299,999
$300,000 - $349,999
$350,000 - $399,999
$400,000 - $449,999
$450,000 - $499,999
$500,000 - $774,999
$775,000 - $999,999
$1,000,000 +
Uncoded/Null
Select All
Home Purchase Date (Premier):
Presence of
Pool:
Automotive
Selections
Probable
Teen Driver:
New/Used
Ind - 1st Vehicle:
New/Used
Ind - 2nd Vehicle:
Dominant
Vehicle Lifestyle Indicator:
Vehicle -
Intend to Purchase:
Buying
Behavior Selections
Online Order - Weeks Since Last Order:
Online Orders - Quantity of Orders:
Online
Orders - Amount of Orders:
Software
Buyer:
Mail Order
Buyer:
Wireless -
Product Buyer:
Life
Event Selections
Life Event
- Child Nearing High School Graduation
Life Event
- New Parent:
Life Event
- Recent Home Buyer:
Life Event
- Recent Mortgage Borrower:
Newlyweds:
Info
Trend Modeling Selections
InfoTrend
Models:
Personicx
Modeling Selections
Personicx
Financial LifeStage Codes:
Personicx
Hispanic:
Personicx
Insurance LifeStage Codes:
Personix
Life Stage Clusters:
Claritas
Modeling Selections
Prizm NE:
P$YCLE NE:
Claritas
Income Producing Assets:
$2,000,000+
$1,000,000 - $2,000,000
$750,000 - $1,000,000
$500,000 - $750,000
$250,000 - $500,000
$100,000 - $250,000
$75,000 - $100,000
$50,000 - $75,000
$25,000 - $50,000
LESS THAN $25,000
Uncoded/Null
Select All
Postcard
Printing Options
Design
Services:
---Select---
I have my
own design artwork
I need my
postcard designed
Postcard
Size:
---Select---
4" x 6" Postcards
5" x 7" Postcards
6" x 9" Postcards
Paper/Stock:
Coating/Finish:
---Select---
Aqueous Both Sides
UV Front/Aqueous
UV Both Sides
UV
Front/No Coat Back (C1S stock)
Proof
Type:
---Select---
No Proof
Email Proof
Overnight Proof
Special Instructions:
Postcard
Mailing Options
Mailing
Services:
---Select---
First Class Postage
I
will mail the Marketing Pieces Myself
Special Instructions:
Please enter the word that you see below.