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MAGNOLIA LIFE INSURANCE AGENCY

WORKPLACE EMPLOYEE BENEFIT COMPANY
 
 
EMPLOYEE INCOME REPLACEMENT LIFE INSURANCE STRATEGIES AND CONCEPTS
 
 
 
 
Term Life Insurance Quote Request
 
 

 
 

 
 

 
 

  Male        Female
 
 

 
 
  •  Recommended that the Head of Household the Family Bread Winner . . .

      Multiply Family Bread Winners Annual Income x 20 = Life Insurance Recommended
 
 

 
 

 All Term Lengths,   5 Years,   10 Years,   15 Years,   20 Years,   25 Years,   30 Years
 
 
Insurance Carrier Choice:     Customize Insurance Carriers
 
 

 Accidental Death Benefit       Wavier of Premium       Return of Premium
 
 



 
 






     

 

TERM LIFE INSURANCE QUOTE INFORMATION REQUEST FORM

 
 
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