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Affordable plans for Tobacco Users

Affordable plans for ages 20-25

Important Tip: We help healthy people get much lower rates on their premium.

Do you currently have Life Insurance?

Yes

No

What is your gender?

Male

Female

Have you used Tobacco Products within the last 12 months?

Yes

No

Are you currently married?

Yes

No

Do you have children?

Yes

No

What is your date of birth?

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Why are you looking for life insurance?

Protect a debt

Cover end of life expenses such as funeral costs

As income replacement

Leave money for family

Leave money to an organization

Other

What is your height?

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What is your weight (lbs)?

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In the past 5 years have you been treated or prescribed medication for any of the following conditions?

anxiety depresson bipolar

cancer

chronic pain

diabetes

heart or circulatory disorder

Otherrespiratory disorder

other medical condition

i have no medical conditions

Are you currently employed?

currently employed

student

stay at home

retired

unemployed

disable

military

What is your zip code?

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First Name

Last Name

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Please provide Email Address?

Please provide Phone Number?

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AmericanLifeCoverage.com 2022

Need advice ? Call (833) 625-0148 to speak to a Licensed Agent

This website is owned and operated by American Life Coverage , a licensed insurance agency. Invitations for applications for insurance on AmericanLifeCoverage.com are made through American Life Coverage, only where licensed and appointed. American Life Coverage license information can be found here

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AmericanLifeCoverage.com 2022

Need advice ? Call (833) 625-0148 to speak to a Licensed Agent

This website is owned and operated by American Life Coverage , a licensed insurance agency. Invitations for applications for insurance on AmericanLifeCoverage.com are made through American Life Coverage, only where licensed and appointed. American Life Coverage license information can be found here

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

© 2022 American Life Coverage - All rights reserved.

© 2022 American Life Coverage - All rights reserved.