First Name:*
Last Name:*
Email:*
Home Phone:*
Business Phone:
Birthdate:	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985
Sex:	Male   Female
Tobacco Use:	Yes   No
Health Class:	Regular   Regular Plus Preferred Preferred Plus
State:	Choose State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dst Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada N. Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Guam Puerto Rico Virgin Islands A. Samoa
Insurance Catagory:	5 Year - Guaranteed Only 10 Year - Guaranteed Only 15 Year - Guaranteed Only 20 Year - Guaranteed Only 25 Year - Guaranteed Only 30 Year - Guaranteed Only 15 Year Term with Return of Premium 20 Year Term with Return of Premium 30 Year Term with Return of Premium
Insurance Amount:	$50,000  $75,000  $100,000  $150,000  $200,000  $250,000  $300,000  $350,000  $400,000  $450,000  $500,000  $600,000  $700,000  $750,000  $800,000  $900,000  $1,000,000  $1,250,000  $1,500,000  $1,750,000  $2,000,000  $2,500,000  $3,000,000  $5,000,000
Premiums Paid:	Annual   Monthly

Types of Key Employee Life Insurance

There are two basic types of life insurance used for key man life policies: term life insurance and universal life or whole life insurance. The type of policy used depends on the specific needs of the business. For example, start-up firms that do not have steady cash flows would use term life insurance because of its relatively low cost and flexibility. On the other hand, more established companies with significant earnings may select universal life or whole life insurance as these policies build cash value which is an asset on the company’s balance sheet and can be accessed anytime at the discretion of the company.

Key (Keyman) Employee Insurance?
Executive Benefits - Rewarding Key Employees
Key Man Life Insurance for Business Owners