"Insurance Quoter"
Provided by:
BEARD FINANCIAL
POB 623
West Chester OH 45071-0623
Quotes are subject to insurance company underwriting and STATE and FEDERAL licensing requirements. We will make every effort to provide you with information to make an informed decision regarding your insurance/investment needs.
Quoting only OHIO at this time. If you are in any other State, please note it in the comments and I will try to find an agent in your area.

All Information Submitted is CONFIDENTIAL!
BOLD=required fields
This is a general form. More information may be needed. OK!
  • Type of Insurance:
  • Your First Name:

  • Your Last Name:

  • Spouse Name:
  • EMail Address:
  • Home/Office Address:

  • City:
    State:
  • Zip : +4 :
  • Phone, include Area Code:

  • Best Time To Call:
    Time Zone:
  • Your Age: Spouse Age (if coverage is to be included:
  • Number of Children (if coverage is to be included): Youngest childs age:
  • Your Sex :MF
  • Smoker? Yes No Spouse Smoker? Yes No

  • General Health Condition:
    You: Spouse:

  • Amount of Insurance:
    You: Spouse:

    For Children:

  • Send Information To:

    • I want information about other financial services, e.g., annuities,
    etc., also. (enter type in comments and check here):

    Type your comments below:

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