40 Industrial Park Rd Ste 301
Plymouth, MA 02360
info@safeharbourinsurance.com
 
Safe Harbour Insurance - At the Registry of Motor Vehicles
"Protection To Weather Any Storm"
 
Call Us Today
508-746-7990
 
 
 
 
 
 

Life Insurance Services in Plymouth, MA

It's hard to lose the ones we love. Financial stress only exacerbates the mourning process. Life insurance provides a safety net for your family in the event of an unexpected death. The coverage includes money for final expenses, debts, including mortgage and many other costs you may leave behind. If you love someone and need to help them past your lifetime, you need assistance from an insurance agency like Safe Harbour Insurance in Plymouth, MA.

Life Insurance Quote

We would like to provide you with a free, no-obligation life insurance quote.
Please provide as much information possible for the most accurate quote.
This information will be kept confidential and will be used for quote purposes only.

Speak to an agent or a live representative....508-746-7990

 
 

Customer Information

Type of Insurance Desired:
Sex
Date of Birth
Marital Status
Used tobacco inpast year

 

Information About Yourself and Family

Please enter information below for all to be covered.
 

Self

 
 
 
 
Weight:
 

Spouse

 
 
 
 
Weight:
 

Parent/Child

 
 
 
 
Weight:
 

Parent/Child

 
 
 
 
Weight:
 
Have you (they) had any of the following health conditions:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

Individual Histories

Please list any individual histories on each person to be covered.
Is person to be insured currently on any prescription medications for ongoing health conditions?
Also, please DISCLOSE any and all health conditions you have (or had in the past):
Is person to be insured currently on any prescription medications for ongoing health conditions?
Also, please DISCLOSE any and all health conditions you have (or had in the past):
Is person to be insured currently on any prescription medications for ongoing health conditions?
Also, please DISCLOSE any and all health conditions you have (or had in the past):
Is person to be insured currently on any prescription medications for ongoing health conditions?
Also, please DISCLOSE any and all health conditions you have (or had in the past):
Is person to be insured currently on any prescription medications for ongoing health conditions?
Also, please DISCLOSE any and all health conditions you have (or had in the past):

 

LIFE COVERAGES

 

Self

 
Type of Coverage:



Disability Income:
Long Term Care:
 

Spouse

 
Type of Coverage:



Disability Income:
Long Term Care:
 

Parent/Child

 
Type of Coverage:



Disability Income:
Long Term Care:
 

Parent/Child

 
Type of Coverage:



Disability Income:
Long Term Care:
 

Child

 
Type of Coverage:



Disability Income:
Long Term Care:
 

 

Health Coverages

 

Self

 
Add Health Coverage?:
 

Spouse

 
Add Health Coverage?:
 

Parent/Child

 
Add Health Coverage?:
 

Parent/Child

 
Add Health Coverage?:
 

Child

 
Add Health Coverage?:
 
Please check desired coverage's below for your health plan.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Please describe other desired coverages (not listed above) here:

 

Additional Comments

Please give any additional comments you feel appropriate for this quotation. If you have additional where there was not enough space, please enter them here.