TOBACCO-USING CLIENTS CAN QUALIFY
FOR NON-SMOKER PREMIUMS WITH
THE STAMM AGENCY

TERM PLANS AVAILABLE – 10, 15, 20, & 30 YEAR LEVEL TERM

CIGAR SMOKERS, SMOKELESS TOBACCO USERS, PIPE SMOKERS, NICOTINE PATCH USERS AND NICORETTE GUM CHEWERS CAN QUALIFY FOR NON-SMOKER PLUS WITH NO LIMIT ON THE AMOUNT OF TOBACCO USE AND EVEN WITH NICOTINE IN THE URINE SPECIMEN.

PERMANENT PLANS AVAILABLE

GUARANTEED DEATH BENEFIT UNIVERSAL LIFE AND JOINT 2ND TO DIE HAVE SAME QUALIFICATIONS AS ABOVE.

PARTICIPATING WHOLE LIFE AND PARTICIPATING JOINT 2ND TO DIE WHOLE LIFE CAN QUALIFY FOR STANDARD NON-SMOKER WITH JOHN HANCOCK WITH ANY TOBACCO USE OTHER THAN CIGARETTES (WITH NO LIMITS ON AMOUNT USED).

CIGARETTE USERS CAN QUALIFY FOR VERY COMPETETIVE PREFERRED PLUS SMOKER RATES.

TO OBTAIN AN ILLUSTRATION, PLEASE COMPLETE THE INFORMATION BELOW AND CLICK SUBMIT. IF YOU WOULD PREFER TO SUBMIT THE INFORMATION BY PHONE – PLEASE CALL US AT 800-327-0176. WE WILL PROMPTLY EMAIL OR FAX THE ILLUSTRATIONS TO YOU.

 
Online Form
Client Name: (if available)
Sex: Male       Female
Date of Birth or Age:
Tobacco Use: Yes       No
--If Yes, Type of tobacco used and frequency:
Amount of Insurance:
Plan of Insurance:
Is this a Replacement? : Yes       No
--If Yes, please provide details (premium needed/previous rating):

Medical History Information:

* * If you have copies of any exams, labs or any reports you wish to add to this, please email or fax (561-368-6722) those to us under separate cover.

 
Agent Name:
Agent Email Address:
Agent Phone Number:
Submit To:
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