Life Insurance Glossary

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(some definitions taken from the National Association of Insurance Commissioners' Life Insurance Buyers Guide)

Your State:
Birthdate:
Sex:	Male Female
Do You Smoke or use Tobacco?:	Yes No
Describe your Health:	Regular Regular Plus Preferred Preferred Plus
Height:	feet inches
Weight:	pounds
Amount of Insurance:
Initial Level Insurance Period:
Quote Premiums:
First Name:
Last Name:
Day Time Phone:	Ext.
Evening Phone:
Email: