UHL/UFFL Premium Quoting
Whole Life:  GIWL - EIWL - EI Deluxe - EI Premier - Provider WL - All Whole Life -- Accidental Death  
Term:  Simple Term 20 - Simple Term 20 DLX - Simple Term 20 ROP - Simple Term 30 - All Term  
** FOR AGENT USE ONLY - NOT TO BE SHOWN TO OR PROVIDED TO CLIENTS **
** A quote is not a guarantee that any coverage will be issued. **
 
    State *  
All Whole Life
Age (age at LAST birthday)
Birth Date * (mm/dd/yyyy)
Sex * Nicotine Use * Payment *
M   F Y   N
Choose Face OR   
      Premium (not both) * 		All Whole Life
GIWL EIWL EI Deluxe EI Premier Provider
Req. Face Amt.  
Req. Premium  
 
Child Rider   NA NA
Accidental Death   NA NA NA
Waiver of Premium   NA NA NA NA Y N
 
 
Quote Results
Face Amt =                      
Premium =                      
Preferred Premium =   NA NA NA NA    
Insurance Age =                      
 
( * = required information)