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| Term Quotes Life Insurance Companies |
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| &nb sp; |
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| | Since 1996, t erm life insurance rates have been reduced by as much | |
| | as 70% | |
| | | |
| | 40 year old male - $250,000 - 10 year level termAs low as $10.44 per | |
| | month! | |
| | | |
| | At TermQuotes Life Insurance Companies of America, we will survey the | |
| | top life insurance companies for you and provide you with the best | |
| | rates available. The quote is free. There is no obligatio n to buy. | |
| | Compare the rates and see for yourself. Fill out this qui ck form | |
| | below for further information. | |
| | | |
| | Results of computer sur vey 07-09-01 | |
| | Sample An nual Premiums | |
| | * 10 Year Level Premium Term Rates * | |
| | +----------------------------------------------------+ | |
| | | Age | $250,000< /B> | $500,000< /B> | $1,000,000 | | |
| | |-----+----------------+----------------+------------| | |
| | | 35 | $115 | $175 | $305 | | |
| | |-----+----------------+----------------+------------| | |
| | | 45 | $210 | $375 | $670 | | |
| | |-----+----------------+----------------+------------| | |
| | | 55 | $500 | $935 | $1,370 | | |
| | |-----+----------------+----------------+------------| | |
| | | 65 | $1,305 | $2,550 | $4,920 | | |
| | |-----+----------------+----------------+------------| | |
| | | 70 | $2,265 | $4,480 | $7,510 | | |
| | +----------------------------------------------------+ | |
| | | |
| | *Above rates guaranteed to remain lev el for 10 years | |
| | Rates based on male preferred class 1 non-smoker | |
| | Policies are guaranteed renewable to age 95 | |
| | Policies with 15, 20, 25, and 30 year level premiums also available | |
| | | |
| | Attention All Smoke rs, | |
| | you may qualify for special reduced smoker rates! | |
| | | |
| | Universal Life, Second-to-Die a nd Estate Planning products also | |
| | provided. | |
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| Submit Thi s Form for a Free Term Insurance Quote! | | |
| +-------------------------------------------------------------------+ | | |
| | +---------------------------------------------------------------+ | | | |
| | |Name Insured: [3D"] | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Amount of Coverage: &nb sp; [$500,000 ] | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Date of Birth: Month [01 ] Day [01 ] Y ear [3D1] | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Sex: Male Female | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Height: FT[ ] in [ ] | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Weight: lbs.[3D" ] | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Occupation: [3D"]< /TR> | | | | |
| | |---------------------------------------------------------------| | | | |
| | |x xx | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Have You Ever Had: | | | | |
| | |---------------------------------------------------------------| | | | |
| | |High Blood Pressure Ye s No | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Heart Attack or Stroke Yes No | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Cancer Yes No | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Diabetes Yes No | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Mother, Father, Sister, Brother Diagnosed or Died of Cancer or | | | | |
| | |Cardiovascular Disease Before Age 60 Yes No | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Have You Smoked Within the Last 12 Months Yes No | | | | |
| | |---------------------------------------------------------------| | | | |
| | |xxx< /font> | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Person Completing Request : [3D"] | | | | |
| | |---------------------------------------------------------------| | | | |
| | | [ ] | | | | |
| | | [ ] | | | | |
| | |Mailing Address: [ ] | | | | |
| | |---------------------------------------------------------------| | | | |
| | |City: [3D"]State [3D"] Zip [3D"] | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Daytime Phone: [3D"] | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Evening Phone: [3D"] | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Email Address: [3D ] | | | | |
| | |---------------------------------------------------------------| | | | |
| | |Best time to contact: [Morning ] | | | | |
| | +---------------------------------------------------------------+ | | | |
| | | | | |
| | When you click submit it may start your spell check, so please | | | |
| | click "Ignore" if it does. | | | |
| +-------------------------------------------------------------------+ | | |
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