LIFE INSURANCE QUOTE

First & Last Name:
Address:
City, State & Zip:
E-Mail:
Telephone:

Self

Name:	Date of Birth:	Sex:	Martial Status:
Ht/Wt	Tobacco Use?	Cancer/Diabetes?	Heart or HBP?
	Yes No
Amt. of Coverage	Type of Coverage	Disability Income	Long Term Care
	Term Whole Universal	Yes No	Yes No

Describe any health problems you have (had) and prescriptions:

Spouse

Name:	Date of Birth:	Sex:	Martial Status:
Ht/Wt	Tabacco Use?	Cancer/Diabetes?	Heart or HBP?
	Yes No
Amt. of Coverage	Type of Coverage	Disability Income	Long Term Care
	Term Whole Universal	Yes No	Yes No

Describe any health problems you have (had) and prescriptions:

Children

Name:	Date of Birth	Amt. of Coverage	Type of Coverage
			Term Whole Universal
			Term Whole Universal
			Term Whole Universal

Additional Comments:

 

Centennial Insurance Group, Inc.™

 

 

I’m not too far removed from my law school contracts class, so I remember all too well the adage, “If it sounds too good to be true… It probably is.” 

That’s what came to mind when Centennial quoted me my rate.  I was sure this was “too good to be true,” because the quote was so much less than what I’d been paying. 

Well, after almost offending my agent by telling him that he was doing something wrong, I received the rates quoted to me. 

Thank you Centennial for the money that you guys are saving me!!!

Matthew S. Gore, Esq.