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Detailed Needs Analysis

Ready for an application? Here's the deeper dive into all the information we require.

Birthday
Sex assigned at birth
male
female
Marital Status?
single
married
separated
divorced
Do you have any dependents under the age of 18?
yes
no
Have you used tobacco products in the past 3 years?
no
yes
Have you used cannabis products in the past 3 years (more than 3 times per week)?
no
yes
Employment level?
unemployed
part-time
full-time
full-time self employed
retired
Existing life insurance amount?
none
Approximate Amount of coverage
Do you own a home?
yes
no/rent
Balance owing on existing mortgages?
none
Approximate amount (within $10,000)
What is your total debt (not including mortgages)?
none
Approximate amount (within $10,000)
What is the value of any additional property you might own (cottage, income unit ...)?
none
Enter the Approximate Amount
Do you have any current or a history of any significant medical conditions? (diabetes, heart problems, high blood pressure, serious mental health issue requiring treatment or similar) Either diagnosed or under medication?
no
yes
Have you ever been Declined, Rated or offered Modified Coverage when applying for Life Insurance?
no
yes
Have you ever been charged with careless or reckless driving?
no
yes
Have you had more than 5 motor vehicle tickets for moving violations in the past 10 years (not including parking tickets)?
no
yes
Have you ever been convicted of a criminal offence?
no
yes
Have you declared bankruptcy in the past 7 years?
no
yes

© 2024 Andrej Kopac. 

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