Section Components
Section / Features 8
Features 8

First, let's cover the basics:

Life insurance is about protecting the people you love. We ask for this information to make sure we recommend enough coverage for your entire family.

What province do you live in?
Do you have a partner?
Yes
No
Your partner date of birth
Your date of birth
Day
Month
Year
Your date of birth
Your date of birth
Day
Month
Year
Do you have any children?
Yes
No
Your children age
What's your gender?
Male
Female
Have you used nicotine or tobacco products in the last 12 months?
Yes
No

Now, onto your finances:

We use this information to figure out how much your family would need if they had to replace your income.

Your partner income
Do you rent or own your house?
Rent
Own
Family’s savings
Please include any personal coverage and coverage through work
Thank you! Your submission has been received!
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