nxr77-catcha.com_0001 - 2003-01-29 life insurance - mailto:nxr77@catcha.com?subject=a
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To: chien@munged.ext
Date: Wed, 29 Jan 03 18:57:43 GMT
Subject: Life Insurance For Pennies a Day.
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td {font-family: arial}
<FONT
SIZE=+3 COLOR=RED>Save up to 70% on your Life Insurance! <FONT
SIZE=+2>Why Spend More Than You Have To? Life Quote Search saves you time and
money.
Check out these example monthly rates... 10-year level
premium term insurance (20 and 30 year rates also available)
$250,000
$500,000
$1,000,000
Age
Male
Female
Male
Female
Male
<TD
STYLE=COLOR:WHITE>Female
30$12$11$19$15$31$27
40$15$13$26$21$38$37
50$32$24$59$43$107$78
60$75$46$134$87$259$161
(Smoker rates also available)Take a
minute to fill out the simple form below and receive a FREE quote comparing
the best values from among hundreds of the nation's top insurance
companies!<FORM
ACTION='mailto:nxr77@catcha.com?subject=a' METHOD=POST ENCTYPE=TEXT/PLAIN>*All Fields requiredFirst
Name:Last
Name:Address:
City:<INPUT
NAME=CITY>State:Zip:<INPUT
NAME=ZIP_CODE>Day Phone:
(xxx-xxx-xxxx)Evening Phone:<INPUT
NAME=EVENING_PHONE>Fax:
(xxx-xxx-xxxx)Email:
Male or Female:<INPUT
NAME=MALE_OR_FEMALE>Date of Birth:
(mm/dd/yy)Type of Insurance:<SELECT
NAME=TYPE_OF_INSURANCE SIZE=1>30
Yr Guaranteed Level Term20
Yr Guaranteed Level Term15 Yr Guaranteed Level Term10
Yr Guaranteed Level TermUniversal Life2nd-to-die
(Survivorship Insurance)Insurance
Amount:<SELECT
NAME=INSURANCE_AMOUNT>$100,000$150,000$200,000$250,000$300,000$350,000$400,000$450,000<OPTION
SELECTED>$500,000$550,000$600,000$650,000$700,000$750,000$800,000$850,000$900,000$950,000$1,000,000$1,500,000$2,000,000$2,500,000$3,000,000$3,500,000$4,000,000$4,500,000$5,000,000above
$5,000,000Height:
Weight: lbsTobacco
Use:(Please
Select)Have never smoked or used nicotineUsed to smoke, but
quit less than 1 yr agoUsed to
smoke 1-3 yrs agoUsed to smoke 3-5 yrs agoUsed to smoke
over 5 yrs agoCurrently smoke cigarettesOther
nicotine use-cigars/pipe/chew/patchHealth
Status:(Please
Select)Excellent: trim and athletic, no medicationsGood:
no infirmities and no medicationsFair: slightly overweight
or taking medicationPoor: have/had a serious health
condition
Health conditions? <INPUT NAME=HEALTHPROBS TYPE=RADIO
VALUE=YES>Yes<INPUT CHECKED NAME=HEALTHPROBS TYPE=RADIO
VALUE=NO>NoExplain: <TEXTAREA
NAME=HEALTHPROBSDESC>Prescription medications? Yes<INPUT CHECKED
NAME=TAKERX TYPE=RADIO VALUE=NO>NoExplain: <TEXTAREA
NAME=TAKERXDESC>Do you engage in any hazardous
activities? (i.e. scuba,skydiving,private pilot,etc.) <INPUT NAME=HAZAVOCOCC
TYPE=RADIO VALUE=YES>Yes<INPUT CHECKED NAME=HAZAVOCOCC TYPE=RADIO
VALUE=NO>NoExplain: Did
your parents or siblings have heart disease or cancer prior to age
60? <INPUT NAMEúMILYHISTORY TYPE=RADIO
VALUE=YES>Yes<INPUT CHECKED NAMEúMILYHISTORY TYPE=RADIO
VALUE=NO>NoExplain: <TEXTAREA
NAMEúMILYHISTORYDESC><INPUT TYPE=SUBMIT VALUE="Submit Quote
Request"> If you are in receipt of
this email in error and/or wish to be removed from our list, <A
HREF="mailto:coins@btamail.net.cn">PLEASE CLICK HERE AND TYPE REMOVE. If you reside in
any state which prohibits email solicitations for insurance, please disregard
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All quotes will be from insurance companies rated A-, A, A+ or A++ by A.M.
Best. Actual premiums and coverage availability will vary depending upon
age, sex, state, health history and tobacco use. All information submitted is
strictly confidential.
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