Common Application Information


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You may be asked to provide the following information on your life insurance application.

Social Security Number - This is required by all insurance companies. Please note that you are on a secure Web site, so it is safe to provide this information on the QuickQuote Web site. However, if you prefer, you can skip this question for now and provide it later.

Tobacco / Nicotine Products - These include cigarettes, cigars, chew, snuff, gum, patches, etc. You will not necessarily be classified as a tobacco user because of past or even current use. You will be able to provide further details later in the application process.

US Citizen - US citizenship is not required. However, non-US citizens may be required to provide further details of citizenship and residency status later in the application process.

Personal Annual Income - An applicant's financial information is among several factors used to determine the amount of insurance the company is able to issue to an applicant. This information is required by ALL insurance companies as they must justify the coverage amounts of all policies they issue. Income multiples are one method of calculating coverage amounts, which is why annual income is required.

Assets - An applicant's financial information is among several factors used to determine the amount of insurance the company is able to issue to an applicant. This information is required by ALL insurance companies as they must justify the coverage amounts of all policies they issue. An applicant's assets can be estimated to include, but are not limited to, savings, investments, real estate, vehicles, personal property, business ownership, etc.

Liabilities - An applicant's financial information is among several factors used to determine the amount of insurance the company is able to issue to an applicant. This information is required by ALL insurance companies as they must justify the coverage amounts of all policies they issue. An applicant's assets can be estimated to include, but are not limited to, savings, investments, real estate, vehicles, personal property, business ownership, etc.

Household Income - An applicant's financial information is among several factors used to determine the amount of insurance the company is able to issue to an applicant. This information is required by ALL insurance companies as they must justify the coverage amounts of all policies they issue. Household income helps insurance companies develop a picture of the family's overall financial position and potential loss in the event of the insured's death.

Net Worth - Net worth is generally considered the amount by which an individual's assets exceed their liabilities (Assets - Liabilities = Net Worth).

An applicant's financial information is among several factors used to determine the amount of insurance the company is able to issue to an applicant. This information is required by ALL insurance companies as they must justify the coverage amounts of all policies they issue. Net worth helps insurance companies develop a picture of the family's overall financial position and potential loss in the event of the insured's death.

Policy Owner - The policy owner is typically the same as the primary insured. In some cases, the policy owner is someone or something else such as a family member, employer or trust. If you are unsure, you can contact us or list the primary insured for now. This can easily be changed later if necessary.

Other Insurance - Please mark 'Yes' if you have an existing life or annuity policy in force with any company. This does not apply to group insurance policies, such as those through an employer or other group.

Primary Beneficiary - This is the person or entity to receive the death benefit proceeds of the policy. More than one can be named, but the total allocation for all primary beneficiaries must equal 100%.

Contingent Beneficiary - This is the person or entity to receive the death benefit proceeds of the policy in the event the primary beneficiary dies prior to or along with the primary insured. More than one can be named, but the total allocation for all contingent beneficiaries must equal 100%.

Visa Type - Visa must be permanent to be eligible for coverage. Please provide exact name of visa (e.g. HB1).

1035 Exchange - A 1035 Exchange refers to a provision in the tax code which allows for the direct transfer of accumulated funds in a life insurance policy, endowment policy or annuity policy to another life insurance policy, endowment policy or annuity policy, without creating a taxable event. Most replacements with a new term life insurance policy are not 1035 Exchanges.

Outstanding Premiums - The insurance company typically collects the first month's premium in the form of a check once the application is approved and the policy is issued. This gives the policy owner the opportunity to review and accept the policy before the first premium is paid. Subsequent monthly premiums are drafted. Checking 'Yes' to draft all outstanding premiums means the first month's premium will also be drafted on the day the policy is issued. Answer 'No' if the policy owner wants to review the policy prior to paying the first monthly premium.



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