Life Plan Financial Group Victoria BC

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Advanced Quote Request

Use this page to request a quote from LifePlan.
Name
Date of Birth	,
Gender	Male Female
Province
Smoking Status
Joint Life Insurance?	Yes No
Joint Insured Name
Joint Insured Date of Birth	,
Joint Insured Gender	Male Female
Joint Insured Smoker Status

Insurance Type
Life Insurance Type	Term UL
Would you like a comparison completed?	Yes No
Would you like a copy of the comparison sent to you?	Yes No

Plan Type
Preferred Supplier
Face Amount	$
Return of Premium on Expiry	Yes No
Return of Premium on Death	Yes No
Coverage Type	Basic Enhanced

Plan Type
Preferred Supplier
Face Amount	$
Target Duration	years

Preferred Supplier
Face Amount	$
Coverage Type
Cost of Insurance	Level YRT
Investment Rate	%
Pay Period	Life To Year
Premium Option	$

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