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What is your primary reason for seeking life insurance?

Select all that apply

Protect my family’s financial future

Cover final expenses

Replace lost income

Pay off debts (e.g., mortgage, loans)

Build cash value for future needs

I’m not sure

How much life insurance coverage are you considering?

Set amount

$50k

$2M+

Do you currently have any life insurance coverage?

Yes, through an employer Yes, an individual policy No, I don’t have coverage

What best describes your health status?

Excellent – No health issues Good – Minor health conditions Fair – Some medical history but manageable Poor – Significant medical conditions

When are you looking to purchase life insurance?

As soon as possible Within the next month Within the next 3-6 months Just researching options

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Thanks for Your Interest in Mutual of Omaha!

We appreciate the opportunity to help you with your life insurance needs. A Mutual of Omaha financial representative will contact you soon.

Once again, thank you for your interest in working with a Mutual of Omaha Agent to find your life insurance solution. We look forward to getting the conversation started!

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