top of page
Cortland Connell
Life Insurance Agency
Get a Quote
About
Products
Testimonials
FAQ
Complete form below to get a Quote for our:
Discounted Final Expense Product
First name
(Required)
Last name
(Required)
Phone
(Required)
State
Email
(Required)
Date of Birth
(Required)
Month
Day
Year
How much premium would you like to get a quote for?
$5,000
$10,000
$15,000
$25,000
Who would you name as your beneficiary?
Child
Spouse
Family Member
If you decide to move forward do you have valid bank account to pay for the monthly premium?
Yes
No
In the past 12 months, have you had a heart attack, stroke, smoked tobacco, have or been diagnosed with cancer, HIV, Alzheimers, dementia, diabetes or lung disease?
Yes
No
Submit for a Free Quote
bottom of page
