Term Life Solutions from Consolidated Insured Benefits
Enter Birthday: or Age:	/ / Actual Age & Nearest Age
Gender:	MaleFemale
Health Class:	All Non-Tobacco Health Classes Preferred Best Non-Tobacco Preferred Non-Tobacco Standard Non-Tobacco - - - - - - - - - - - - - - - - - - - - All Tobacco Health Classes Preferred Tobacco Standard Tobacco
Amount of Insurance:	Determine Amount
State:	- - Select a State - - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Guam Hawaii Hong Kong Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming
Desired Term Length:	All Terms 5 Year Term 10 Year Term 15 Year Term 20 Year Term 25 Year Term 30 Year Term All Terms Guaranteed 5 Years Guaranteed 10 Years Guaranteed 15 Years Guaranteed 20 Years Guaranteed 25 Years Guaranteed 30 Years Guaranteed
Company:	- - All Carriers - - Allianz Life Insurance Company of North America American General Life Assurity Life Insurance Company North American Company for Life and Health Insurance Old Republic Life West Coast Life
Product:	- - All Products - -
Accidental Death Benefit:	Yes No
Waiver of Premium:	Yes No
Child Rider Units:	$ 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 10,000
Table Ratings:	None 1 or A 2 or B 3 or C 4 or D 5 or E 6 or F 7 or G 8 or H 9 or I 10 or J
Flat Extra:
Number of Years Flat Extra Applies:
Return of Premium:	Yes No