Life Insurance by Baxter Insurance.

Top Insurers. Local Agents. Great Rates. We make applying for life insurance easy. Thousands of homes insured since 1989. 1. Complete this life insurance application. 2. We will prepare your quote right away and email it to you. 3. Ready to purchase? It is all online/phone. Bye bye paper apps. Have a question? Email: service@baxterinsurance.com Phone: 805-963-4048 www.baxterinsurance.com Our Team is always here to help. Now Let's Get Started On Your Life Insurance Quote: (Estimated Time to Complete - 6 Minutes)

Initial Questions:

Which of These Describes Your Situation?*

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When Do You Need Coverage To Start?*

Life insurers can take a long time to process applications once you apply. Anywhere from 2-6 weeks. Much of that time is just waiting. We know, it is a long time in this modern world. Better to apply sooner rather than later!

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What is Your Home Zip Code?*

Questions About You:

Gender*

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What is Your Date of Birth?*

What is Your Occupation?*

Are You A US Citizen or Permanent Resident?*

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Do You Have A Green Card?

How Long Will You Be In The US?

What is Your Country of Citizenship?

Do You Have a Spouse or Partner?*

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Do You Want a Quote For Your Spouse / Partner?

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What is Your Height?*

Please List Your Height n Feet and Inches

What Is Your Weight?*

Please List Your Weight In Pounds

Some Underwriting Questions:

Any Tobacco Product Use In Past 5 Years?*

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What Year Did You Last Use Tobacco?

How Many Days a Month Do You Use Tobacco?

What Tobacco Products Do You Use?

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Been Treated Or Take Meds For The Following?*

Health history is very important to offering you realistic rates. Life insurers will find out once you apply by ordering your medical records. Better to get this up front than to avoid surprises later. Your information is strictly confidential.(Select All That Apply)

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Please Describe "Other Serious Condition"

Do You Have Any Foreign Travel Planned?*

Do You Have Any Trips Abroad Planned In The Next 24 Months?

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What Is The Purpose Of The Foreign Travel?

Select or enter value

Which Countries Might You Visit?

How Many Weeks Annually Will You Spend Abroad?

Have Your Parents or Siblings Before Age 70:*

Insurers take into account health history of your direct biological parents and siblings on their applcations.

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Driving Record, In the Past 5 Years Any?*

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Do You Participate In?*

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What Amount Of Coverage Are You Looking For?*

Select a coverage range. We will send you quotes with three coverage options around the range you selected. We can always revise quotes later.

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What Length of Coverage Are You Looking For?*

Select a desired policy type. We will send your quote with three policy term lengths around the option you selected.

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Where Shall We Send Your Quotes?

Email*

Your privacy is important to us. We will send your quotes here.

Your First Name*

Your Last Name*

Phone*

We will call you in case we need additional information from you.

How Did You Find Our Office?*

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Who Referred You To Our Office?

So we can thank them!

Are You Interested In Bundling More Policies?*

We write all of personal, business, and health insurance policies. Bundling can result in savings, having one insurance adviser to call on, and simplicity.

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File Upload

You Can Upload and Documents Here if You Need To. (e.g copies of your current life insurance policies, etc.)

Drag and drop files here or

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