Andries Insurance Agency
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LIFE QUOTE
LIFE INSURANCE
Privacy Notice: All information you provide is solely used for the purpose of providing you with quotes. We will never sell, give, or otherwise transfer
your personal information to any person or entity other than the insurance companies, agents, and representatives selected. In some cases insurance
companies we work with may request credit score.

The most valuable possession that your family
owns is your
EARNING POWER.
Life I
nsurance coverage can help safeguard
your family’s financial security by providing an
immediate estate that can be used for:

Family Needs        

*Pay off a mortgage balance    
*Help fund a child’s college education
*Provide family income    
*Pay off personal debts
*Pay final expenses   

Business Needs

*Key Person coverage
*Security for a business loan
*Funding for a Buy/Sell agreement
*Low-cost optional employment benefit


If you had a goose that was laying golden
eggs, would you insure the goose or the eggs?
Many of us are guilty of insuring  only the
eggs. Would you agree It’s time to insure the
goose?
State
Zip:
Street Adress:
City:
First & Last  Name:
County:
Phone:
Email:
Date of birth or Age:
Height:
Weight:
Gender:
Tobacco User:
Male:
No
Female
Yes
Amount of Coverage:
Type of Policy:
Term of Policy:
Term:
1 Year:
Permanent:
5 Year:
10 Year:
15 Year:
20 Year:
25 Year:
30 Year:
Comments:
Thanks for your time, please submit