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State:
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Amer. Samoa
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
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
Gender:
Male
Female
Smoker/Tobacco:
Yes
No
Health Class:
Preferred Plus
Preferred
Regular Plus
Regular
Type of Insurance:
1 Year Level Term
5 Year Level Term
10 Year Level Term
15 Year Level Term
20 Year Level Term
25 Year Level Term
30 Year Level Term
35 Year Level Term
40 Year Level Term
To Age 65 Level
To Age 70 Level
To Age 75 Level
To Age 80 Level
To Age 85 Level
To Age 90 Level
To Age 95 Level
To Age 100 Level
To Age 105 Level
To Age 110 Level
Other Term
10, 20, 30 Year Term
All Level Term Product Categories
10 Year Return of Premium
15 Year Return of Premium
20 Year Return of Premium
25 Year Return of Premium
30 Year Return of Premium
To age 65 Return of Premium
To age 70 Return of Premium
To age 75 Return of Premium
Other Return of Premium
15, 20, 30 Year with ROP
Return of Premium Products
To Age 121 Level (No Lapse U/L)
To Age 121 Level - Pay to 100
To Age 121 Level - Pay to 65
To Age 121 Level - 20 Pay
To Age 121 Level - 10 Pay
To Age 121 Level - Single Pay
Face Amount:
$10,000
$25,000
$50,000
$50,000
$75,000
$100,000
$125,000
$150,000
$175,000
$200,000
$225,000
$250,000
$300,000
$350,000
$400,000
$450,000
$500,000
$550,000
$600,000
$650,000
$700,000
$750,000
$800,000
$900,000
$1,000,000
$1,100,000
$1,250,000
$1,500,000
$1,750,000
$2,000,000
$2,500,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
$7,000,000
$8,000,000
$9,000,000
$10,000,000
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