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Life Quote Form
Please fill in the form below to receive your free life quote:
Birth Date
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Gender
Male
Female
Tobacco use
Yes
No
Province
British Columbia
Alberta
Saskatchewan
Northewest Territories
Yukon Territory
Nunavit
Manitoba
Ontario
Quebec
Nova Scotia
New Brunswick
Prince Edward Island
Newfoundland
All Provinces
Face Amount
Face Amount
$ 25,000
$ 30,000
$ 35,000
$ 40,000
$ 45,000
$ 50,000
$ 55,000
$ 60,000
$ 65,000
$ 70,000
$ 75,000
$ 80,000
$ 85,000
$ 90,000
$ 95,000
$ 100,000
$ 125,000
$ 150,000
$ 175,000
$ 200,000
$ 225,000
$ 250,000
$ 275,000
$ 300,000
$ 325,000
$ 350,000
$ 375,000
$ 400,000
$ 425,000
$ 450,000
$ 475,000
$ 500,000
$ 550,000
$ 600,000
$ 650,000
$ 700,000
$ 750,000
$ 800,000
$ 850,000
$ 900,000
$ 950,000
$1,000,000
$1,250,000
$1,500,000
$1,750,000
$2,000,000
$2,250,000
$2,500,000
$2,750,000
$3,000,000
$3,500,000
$4,000,000
$4,500,000
$5,000,000
$6,000,000
$7,000,000
$8,000,000
$9,000,000
$10,000,000
$11,000,000
$12,000,000
$13,000,000
$14,000,000
$15,000,000
$16,000,000
$17,000,000
$18,000,000
$19,000,000
$20,000,000
$21,000,000
$22,000,000
$23,000,000
$24,000,000
$25,000,000
$26,000,000
$27,000,000
$28,000,000
$29,000,000
$30,000,000
Premium Payment
Premium mode
Annual
Semi-Annual
Quarterly
Monthly
Product Type
10 year Term
15 year Term
20 year Term
25 Year Term
30 Year Term
35 Year Term
40 Year Term
Level term to 65
Level term to 70
Level term to 75
Unique Term
OptiTerm
Traditional Term 100
T100 20-Pay
Unique Term 100
Whole Life / Life Pay
Whole Life / Pay to 65
Whole Life / 25 Pay
Whole Life / 20 Pay
Whole Life / 15 Pay
Whole Life / Quick Pay
Unique Whole Life
Single Person Funeral Plan
10 year Term
11 year Term
12 year Term
13 Year Term
14 Year Term
15 Year Term
16 Year Term
17 Year Term
18 Year Term
19 Year Term
20 year Term
21 year Term
22 year Term
23 Year Term
24 Year Term
25 Year Term
26 Year Term
27 Year Term
28 Year Term
29 Year Term
30 year Term
31 year Term
32 year Term
33 Year Term
34 Year Term
35 Year Term
36 Year Term
37 Year Term
38 Year Term
39 Year Term
40 year Term
Underwriting Risk
Super Preferred
Preferred
Regular
Simplified
Guaranteed
