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Check out these example monthly rates...
10-year level premium term insurance
(20 and 30 year rates also available)

		$250,000		$500,000		$1,000,000	
Age	Male	Female	Male	Female	Male	Female	
30	$12	$11	$19	$15	$31	$27	
40	$15	$13	$26	$21	$38	$37	
50	$32	$24	$59	$43	$107	$78	
60	$75	$46	$134	$87	$259	$161	

(Smoker rates also available)
Take a minute to fill out the simple form below and receive a FREE quote
comparing the best values from among hundreds of the nation's top insurance companies!

*All Fields required	First Name:		
Last Name:			
Address:			
City:			
State:			
Zip:			
Day Phone:	(xxx-xxx-xxxx)		
Evening Phone:			
Fax:	(xxx-xxx-xxxx)		
Email:			
Male or Female:			
Date of Birth:	(mm/dd/yy)		
Type of Insurance:	30 Yr Guaranteed Level Term20 Yr Guaranteed Level Term15 Yr Guaranteed Level Term10 Yr Guaranteed Level TermUniversal Life2nd-to-die (Survivorship Insurance)		
Insurance Amount:	$100,000$150,000$200,000$250,000$300,000$350,000$400,000$450,000$500,000$550,000$600,000$650,000$700,000$750,000$800,000$850,000$900,000$950,000$1,000,000$1,500,000$2,000,000$2,500,000$3,000,000$3,500,000$4,000,000$4,500,000$5,000,000above $5,000,000		
Height:			
Weight:	lbs		
Tobacco Use:	(Please Select)Have never smoked or used nicotineUsed to smoke, but quit less than 1 yr agoUsed to smoke 1-3 yrs agoUsed to smoke 3-5 yrs agoUsed to smoke over 5 yrs agoCurrently smoke cigarettesOther nicotine use-cigars/pipe/chew/patch		
Health Status:	(Please Select)Excellent: trim and athletic, no medicationsGood: no infirmities and no medicationsFair: slightly overweight or taking medicationPoor: have/had a serious health condition		
Health conditions? YesNo	Explain: 		
Prescription medications? YesNo	Explain: 		
Do you engage in any hazardous activities? (i.e. scuba,skydiving,private pilot,etc.) YesNo	Explain: 		
Did your parents or siblings have heart disease or cancer prior to age 60? YesNo	Explain: 		


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      We will open your email application to submit your inquiry. All quotes will be from insurance companies rated A-, A, A+ or A++ by A.M. Best. Actual premiums and coverage availability will vary depending upon age, sex, state, health history and tobacco use. THIS IS NOT AN OFFER OR CONTRACT TO BUY INSURANCE PRODUCTS, but rather a confidential informational inquiry.  Life Quote Search is an information gathering service and does not sell insurance.  All information submitted is strictly confidential, and will be given to an insurance professional licensed in your state of residence, who will contact you and provide your quote directly.