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LIFE INSURANCE

Why should I buy life insurance?

Many financial experts consider life insurance to be the cornerstone of sound financial planning. It can be an important tool in the following situations

Replace income for dependents

If people depend on your income, life insurance can replace that income for them if you die. The most commonly recognized case of this is parents with young children. However, it can also apply to couples in which the survivor would be financially stricken by the income lost through the death of a partner, and to dependent adults, such as parents, siblings or adult children who continue to rely on you financially. Insurance to replace your income can be especially useful if the government- or employer-sponsored benefits of your surviving spouse or domestic partner will be reduced after your death.

Pay final expenses

Life insurance can pay your funeral and burial costs, probate and other estate administration costs, debts and medical expenses not covered by health insurance.

    Name

    Email

    Phone

    Occupation

    Resident State

    Date of Birth

    Male/Female MaleFemale

    Citizenship Status

    Current Height

    Current Weight:

    Has there been major weight changes in the last 12 months?

    Tobacco Usage
    Do you currently use or in the last 5 yrs used any Tobacco or Nicotine based product? If yes,
    provide details

    Do you have any medical history of the following? (Y/N) YesNo

    Coronary Artery Disease/Heart Related Diseases YesNo

    Diabetes YesNo

    CancerYesNo

    Cerebral Vascular Disease or StrokeYesNo

    Hepatitis YesNo

    Alcohol/Drug Abuse Treatment in last 10 yrs YesNo

    Depression/Anxiety Treatment YesNo

    Abnormal Labs (ex. Liver or Renal Functions) YesNo

    Gastrointestinal (ex. Crohn’s, Ulcerative Colitis) YesNo

    Sleep Apnea YesNo

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