Get Senior Benefits Organization

Attention Seniors Ages 50-85

You are entitled to receive no-cost information as a resident of your state. IMPORTANT - Respond with the information below within 5 days.

Please click the “Next” button below to get started and see what you qualify for.

Full Name

Type your full name.

Zip Code

Type the 5-digit zip code of where you live.

Current Age

Type your current age.

Coverage Amount Requested

Please select from the list provided the coverage amount you would prefer your family to receive from your insurance policy in the event of your passing.

Current Smoking Status

Tell us about your smoking. This helps figure out your insurance price. Choose 'Non-Smoker' if you don’t smoke, 'Current Smoker' if you smoke now, or 'Former Smoker' if you used to smoke. Pick the one that matches you.

Beneficiary Designation: Name and Relationship

Who should benefit from your insurance policy? It could be your spouse, children, a charity, or someone else you want to support. Write their name and how they are related to you.

Favorite Color

Type your favorite color in the box below.

Phone Number

Write your phone number in the box below.

Email Address

Enter Your Email Address

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