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Our Contact Information 

All Insurance Underwriters
2600 Sumerian Dr., Suite 101
Land O' Lakes, FL 34638

Toll Free: (877) 977-2667
Telephone: (813) 343-3100
Fax: (813) 920-7771
Email Us

 

All Industry Underwriters, Inc. is a BBB Accredited Business. Click for the BBB Business Review of this Business Consultants in Land O Lakes FL
 Group Life Quote
Group Life Quote Request

Contact Information
Full Name:
Day Telephone:
Company Name:
Eve Telephone:
Street Address:
Fax:
City, State & Zip:
Best Time To Reach You:
E-Mail Address:
Current Insurance Information
If currently covered list carrier, # of years covered, and type of coverage
Employee Information
(If More Than 10 Employees, please call us to
receive a large group census form.)
List employees' required census data: (If More Than 10 Employees, place call us to
receive a large group census form.)
Employee #01 Status:
Age: Gender (M/F):
Employee #02 Status:
Age: Gender (M/F):
Employee #03 Status:
Age: Gender (M/F):
Employee #04 Status:
Age: Gender (M/F):
Employee #05 Status:
Age: Gender (M/F):
Employee #06 Status:
Age: Gender (M/F):
Employee #07 Status:
Age: Gender (M/F):
Employee #08 Status:
Age: Gender (M/F):
Employee #09 Status:
Age: Gender (M/F):
Employee #10 Status:
Age: Gender (M/F):
Coverage Information
Amount of Coverage Desired?
Type of Coverage? (Term, Universal life, Other):
TERM = Pays death benefit only - This is lowest cost for coverage.
UNIVERSAL LIFE = Has savings aspect in addition to providing death benefit.
OTHER = Would be mortgage protection, whole life, etc.

Years of Level Premium:
Reason for Buying Life Insurance:
Any additional comments or information that might
be helpful in your quote

No coverage of any kind is bound or implied by submitting information via this online form

  • We will only use information provided to assist in obtaining appropriate insurance quotes and coverage.
  • We will not distribute information to other parties other than for insurance underwriting purposes.
  • By submitting this form, you agree to release us from any liability should this information be accidentally viewed by others.

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