Life Insurance QuoteInsured: ______________________________________________________Date of Birth: _____________________ Gender: ___________________Resident State: ____________________

Plan of Insurance: ______________________________________________Face Amount: _____________________ Premium Commitment: _______________ Mode: __________________

My Agent: _____________________________________________________Phone: _______________________________________________________Email: ________________________________________________________

200-613 fill-in 10-18

800-428-3001 | www.unitedhomelife.com

THIS QUOTE IS NOT A POLICY CONTRACT.

We’ve been in the business of providing invaluable life insurance coverage since 1948 and 1937, respectively. Our companies are financially strong as evidenced by our ratings from A.M. Best, a leading independent analyst of the insurance industry since 1899. A.M. Best has assigned a financial strength rating of A- (Excellent) to United Home Life; United Farm Family Life’s financial strength rating is A (Excellent).1

And combined, we have more than $2 billion in assets and over $20 billion of life insurance in force so we’re well-positioned to meet our obligations to our policyowners.

Whole Life Insurance Products:

Provider Express Issue Premier Express Issue Deluxe

Express Issue Guaranteed Issue

Term Life Insurance Products:

Simple Term 20Simple Term 30

Simple Term 20 ROPSimple Term 20 DLX

At United Home Life/United Farm Family Life, we’ve made it simple to purchase a� ordable life insurance coverage without medical exams or bodily fluids testing, even if you’ve been turned down before. Just complete a short application with yes/no health questions to determine eligibility, and participate in a brief personal history interview by phone. It’s that simple.

1The 4th and 3rd highest ratings, respectively, of 16 ratings.Product/Rider availability varies by issue age and by state.

Accidental Death Benefit Coverage Product:

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The Companies Behind Your Protection

Life Insurance Made Simple

800-428-3001 | www.unitedhomelife.com