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<table border="0" cellpadding="0" cellspacing="0" width="760">
<tr>
    <td valign="top" width="817">
    <center>
    <div class="fixed" style="width: 536; height: 806">

<body bgcolor="WHITE">
<form action="" method="post" name="null">
  <div align="center">
    <center>
  <table border="0" cellspacing="0" cellpadding="2" style="border-collapse: collapse" bordercolor="#111111" width="678">
    <tr bgcolor="#FFFFFF"> 
      <td colspan="2" height="15" bgcolor="#DAD492" width="883"> 
        <div align="center"> <font color="#FF0000" face="Courier"><b>
          <font face="Arial Black" size="2">Quick </font></b></font><b>
          <font face="Arial Black" size="2" color="#FF0000">Needs Analysis</font><font color="#FF0000" face="Arial Black"> 
          I</font></b></div>
      </td>
    </tr>
    <tr bgcolor="#666600"> 
      <td colspan="2" bgcolor="#0000FF" width="883">
      <p align="center"><font color="#333300" face="arial,helvetica" size="-1"><b><font color="#FFFFFF">This 
        "Quick Needs Analysis" will provide you with an
      estimate of the amount of 
        life insurance needed to
      replace a deceased wage earner's income. <br>
      <i>*If you 
        need a more precise calculation,
      please scroll down to <br>
      our &quot;Quick 
      Needs Analysis II&quot;.</i></font></b></font></td>
    </tr>
    <tbody> 
    <tr> 
      <td width="726" height="51" bgcolor="#BABEF3" align="right"> 
        <p><font face="arial,helvetica" size="2"> Enter the annual 
          replacement income that will be needed
        if the insured dies prematurely 
          (before-tax).</font></p>
      </td>
      <td width="153" height="51" bgcolor="#BABEF3"> 
        <p align="right"> <font color="#333300"> 
          <select name=tfAmount>
            <option 
              value=10000>10000 
            <option value=15000>15000 
            <option 
              value=20000>20000 
            <option value=25000>25000 
            <option  
              value=30000>30000 
            <option value=35000>35000 
            <option 
              value=40000>40000 
            <option value=45000>45000 
            <option 
              value=50000>50000 
            <option value=55000>55000 
            <option selected
              value=60000>60000 
            <option value=65000>65000 
            <option 
              value=70000>70000 
            <option value=75000>75000 
            <option 
              value=80000>80000 
            <option value=85000>85000 
            <option 
              value=90000>90000 
            <option value=95000>95000 
            <option 
              value=100000>100000 
            <option value=110000>110000 
            <option 
              value=120000>120000 
            <option value=130000>130000 
            <option 
              value=140000>140000 
            <option value=150000>150000 
            <option 
              value=160000>160000 
            <option value=170000>170000 
            <option 
              value=180000>180000 
            <option value=190000>190000 
            <option 
              value=200000>200000 
            <option value=225000>225000 
            <option 
              value=250000>250000 
            <option value=275000>275000 
            <option 
              value=300000>300000 
            <option value=325000>325000 
            <option 
              value=350000>350000 
            <option value=375000>375000 
            <option 
              value=400000>400000 
            <option value=425000>425000 
            <option 
              value=450000>450000 
            <option value=475000>475000 
            <option 
              value=500000>500000 
            <option value=750000>750000 
            <option 
              value=1000000>1000000</option>
          </select></font> </p>
      </td>
    </tr>
    <tr> 
      <td width="726" height="43" bgcolor="#BABEF3" align="right"> 
        <p><font face="arial,helvetica" size="2">Enter the number 
          of years the replacement income <br>
        will be needed by dependents / beneficiaries.</font></p>
      </td>
      <td width="153" height="43" bgcolor="#BABEF3"> 
        <p align="right"> <font color="#333300"> 
          <select name=tfLen>
            <option value=5>5 
            <option selected value=10>10 
            <option value=15>15 
            <option 
              value=20>20 
            <option value=25>25 
            <option value=30>30 
            <option 
              value=35>35 
            <option value=40>40</option>
          </select></font> </p>
      </td>
    </tr>
    <tr> 
      <td width="726" height="41" bgcolor="#BABEF3" align="right"> 
        <p><font face="arial,helvetica" size="2">Please estimate 
          the average annual interest rate you can earn on the invested life insurance 
          proceeds. 
          (%)</font></p>
      </td>
      <td width="153" height="41" bgcolor="#BABEF3"> 
        <p align="right"> <font color="#333300"> 
          <select name=tfRate>
            <option value=.04>4 % 
            <option value=.05>5 % 
            <option selected value=.06>6 % 
            <option 
              value=.07>7 % 
            <option value=.08>8 % 
            <option value=.09>9 % 
            <option 
              value=.10>10 % 
            <option value=.12>12 %</option>
          </select></font> </p>
      </td>
    </tr>
    <tr> 
      <td width="726" height="41" bgcolor="#BABEF3" align="right"> 
        <p><font face="arial,helvetica" size="2">Enter your estimate 
          of the average annual inflation rate.&nbsp;<em>(The 
          average rate for the last 10 years has been approximately 3 %)</em></font></p>
      </td>
      <td width="153" height="41" bgcolor="#BABEF3"> 
        <p align="right"> <font color="#333300"> 
          <select name=tfInflation>
            <option 
              value=.02>2 % 
            <option selected value=.03>3 % 
            <option value=.04>4 % 
            <option value=.05>5 % 
            <option value=.06>6 % 
            <option value=.07>7 % 
            <option value=.08>8 %</option>
          </select></font> </p>
      </td>
    </tr>
    <tr> 
      <td width="726" valign="middle" bgcolor="#001469" align="right"> 
        <p><font face="Arial"><b>
          <font color="#FFFFFF">Click on "Compute" to calculate t</font></b></font><font face="arial,helvetica"><b><font color="#FFFFFF">he 
          amount of <br>
        life insurance needed to replace a deceased's lost annual 
          income then click Continue get a quote:</font></b></font></p>
        <p><a href="Life-Form.html"><img border="0" src="images/A-continue.gif" width="113" height="34"></a></p>
      </td>
      <td width="153" bgcolor="#001469"> 
        <p align="right"> 
        <p align="right"></p>
        <p align="right"><font color="#333300"> 
          <input name="Button" onClick=compute(this.form) type=button value=Compute></font> </p>
        <p align="right"></p>
        <p align="right"><font color="#333300"> 
          <input name=tfPay onChange=computeField(this) 
            size=14 
      value=0></font>
          <br>
          </p>
      </td>
    </tr>
    </tbody> 
  </table>
    </center>
  </div>
</form>
<font 
      color="black"></font> 
<p></p>
<p><b><i><font color="#FF0000">For more accurate calculation, please fill in your information below.</font></i></b></p>
<form name="ins">

<DIV align="center">
				<center>
      <TABLE align="center" border="0" cellpadding="1" cellspacing="1" height="622" width="667" 
name="calculator">
        <TR align="middle" bgcolor="#FFFFFF"> 
          <TD align="left" colspan="2" height="18" bgcolor="#FF0000" width="663"> 
            <div align="center"> <font color="#FFFFFF" face="Courier"><b>
              <font face="Arial Black" size="2">Quick </font></b></font><b>
              <font face="Arial Black" size="2" color="#FFFFFF">Needs Analysis</font><font color="#FFFFFF" face="Arial Black"> 
              II</font></b></div>
          </TD>
        </TR>
        <TBODY> 
        <TR align="middle" bgcolor="#666600"> 
          <TD align="left" colspan="2" height="18" bgcolor="#008080" width="663"> 
            <DIV align="left"> 
              <P><font color="#003300"><STRONG><font face="Arial" size="2" color="#FFFFFF">Step 
                1. Evaluate Your Income & Assets</font><font color="#FFFFFF"><SMALL><SMALL> 
                </SMALL></SMALL></font></STRONG></font></P>
            </DIV>
          </TD>
        </TR>
        <TR align="middle"> 
          <TD align="left" height="25" bgcolor="#008080" width="541"><font color="#FFFFFF"><SMALL><FONT face="Arial">Your 
            current income is? </FONT></SMALL></font></TD>
          <TD align="middle" height="25" bgcolor="#008080" width="119"> 
            <DIV align="left"><FONT color="black"> 
              <P><font color="#003300"><SMALL><FONT face="Arial"><SMALL>$</SMALL> 
                <INPUT maxlength="15" 
      name=annincome onchange=AddIt(); size=10 value=0>
                </FONT></SMALL></font></P>
              </FONT></DIV>
          </TD>
        </TR>
        <TR align="middle"> 
          <TD align="left" height="34" bgcolor="#008080" width="541"><font color="#FFFFFF"><SMALL><FONT face="Arial">How 
            many years will your spouse need your annual income? </FONT></SMALL></font></TD>
          <TD align="middle" height="34" bgcolor="#008080" width="119"> 
            <DIV align="left"> 
              <P><font color="#003300"><SMALL><FONT face="Arial">&nbsp; 
                <SELECT 
      name=selectyrs onchange=AddIt(); size="1">
                  <OPTION value="1">1 Year</OPTION>
                  <OPTION value="2">2 Years</OPTION>
                  <OPTION value="3">3 Years</OPTION>
                  <OPTION value="4">4 Years</OPTION>
                  <OPTION value="5">5 Years</OPTION>
                  <OPTION value="6">6 Years</OPTION>
                  <OPTION value="7">7 Years</OPTION>
                  <OPTION value="8">8 Years</OPTION>
                  <OPTION value="9">9 Years</OPTION>
                  <OPTION selected value=10>10 Years</OPTION>
                  <OPTION value="15">15 Years</OPTION>
                  <OPTION value="20">20 Years</OPTION>
                  <OPTION value="25">25 Years</OPTION>
                  <OPTION value="30">30 Years</OPTION>
                </SELECT>
                </FONT></SMALL></font></P>
            </DIV>
          </TD>
        </TR>
        <TR align="middle"> 
          <TD align="left" height="34" bgcolor="#008080" width="541">
          <font color="#FFFFFF" face="Arial"><SMALL>Current 
            investment income</SMALL> <FONT size="2">(Rental Properties, Dividends, 
            Annuities, etc.)</FONT><SMALL> </SMALL></font></TD>
          <TD align="middle" height="34" bgcolor="#008080" width="119"> 
            <DIV align="left"><FONT color="black"> 
              <P><font color="#003300"><SMALL><FONT face="Arial"><SMALL>$</SMALL> 
                <INPUT maxlength="15" 
      name=invstinc onchange=AddIt(); size=10 value=0>
                </FONT></SMALL></font></P>
              </FONT></DIV>
          </TD>
        </TR>
        <TR align="middle"> 
          <TD align="left" height="46" bgcolor="#008080" width="541">
          <font color="#FFFFFF" face="Arial"><SMALL>Existing 
            liquid assets - </SMALL><FONT size="2">All assets that can be turned 
            into cash within 3 months <BR>
            (We recommend you not liquidate retirement accounts due to tax penalties) 
            </FONT></font></TD>
          <TD align="middle" height="46" bgcolor="#008080" width="119"> 
            <DIV align="left"> 
              <P><font color="#003300"><SMALL><FONT face="Arial"><SMALL>$</SMALL> 
                <INPUT maxlength="15" 
      name=liqassets onchange=AddIt(); size=10 value=0>
                </FONT></SMALL></font></P>
            </DIV>
          </TD>
        </TR>
        <TR align="middle"> 
          <TD align="left" height="34" bgcolor="#008080" width="541">
          <font color="#FFFFFF" face="Arial"><SMALL>The 
            amount of your existing life insurance coverage:</SMALL></font></TD>
          <TD align="middle" height="34" bgcolor="#008080" width="119"> 
            <DIV align="left"><FONT color="black"> 
              <P><font color="#003300"><SMALL><FONT face="Arial"><SMALL>$</SMALL> 
                <INPUT maxlength="15" 
      name=inscoverage onchange=AddIt(); size=10 value=0>
                </FONT></SMALL></font></P>
              </FONT></DIV>
          </TD>
        </TR>
        <TR align="middle" bgcolor="#666600"> 
          <TD align="left" colspan="2" height="18" bgcolor="#008080" width="663"> 
            <DIV align="left"> 
              <P><font color="#003300"><STRONG><font face="Arial" size="2" color="#FFFFFF">Step 
                2. Evaluate Your Debts and Expenses</font><font face="Arial" color="#FFFFFF"><SMALL><SMALL> 
                </SMALL></SMALL></font></STRONG></font></P>
            </DIV>
          </TD>
        </TR>
        <TR align="middle"> 
          <TD align="left" height="25" bgcolor="#008080" width="541">
          <font color="#FFFFFF" face="Arial"><SMALL>Outstanding 
            mortgage balance:</SMALL></font></TD>
          <TD align="left" height="25" bgcolor="#008080" width="119"> 
            <DIV align="left"><FONT color="black"> 
              <P><font color="#003300"><SMALL><FONT face="Arial"><SMALL>$</SMALL> 
                <INPUT maxlength="15" 
      name=outsmbalance onchange=AddIt(); size=10 value=0>
                </FONT></SMALL></font></P>
              </FONT></DIV>
          </TD>
        </TR>
        <TR align="middle"> 
          <TD align="left" height="25" bgcolor="#008080" width="541">
          <font color="#FFFFFF" face="Arial"><SMALL>Outstanding 
            loans:</SMALL></font></TD>
          <TD align="left" height="25" bgcolor="#008080" width="119"> 
            <DIV align="left"> 
              <P><font color="#003300"><SMALL><FONT face="Arial"><SMALL>$</SMALL> 
                <INPUT maxlength="15" 
      name=outloans onchange=AddIt(); size=10 value=0>
                </FONT></SMALL></font></P>
            </DIV>
          </TD>
        </TR>
        <TR align="middle"> 
          <TD align="left" height="25" bgcolor="#008080" width="541">
          <font color="#FFFFFF" face="Arial"><SMALL>Final 
            expenses:</SMALL></font><font color="#FFFFFF" face="Arial" size="1"> 
            </font><font color="#FFFFFF" face="Arial" size="2">(Medical, Funeral, 
            Taxes)</font></TD>
          <TD align="left" height="25" bgcolor="#008080" width="119"> 
            <DIV align="left"><FONT color="black"> 
              <P><font color="#003300"><SMALL><FONT face="Arial"><SMALL>$</SMALL> 
                <INPUT maxlength="15" 
      name=finalexp onchange=AddIt(); size=10 value=15000>
                </FONT></SMALL></font></P>
              </FONT></DIV>
          </TD>
        </TR>
        <TR align="middle" bgcolor="#666600"> 
          <TD align="left" colspan="2" height="18" bgcolor="#008080" width="663"> 
            <DIV align="left"> 
              <P><font color="#003300"><STRONG><FONT 
      face="Arial"><SMALL><font color="#FFFFFF">Step 3. Evaluate Your Child Support 
                </font></SMALL><font size="2" color="#FFFFFF">and</font><font color="#FFFFFF"><SMALL><SMALL> 
                </SMALL></SMALL></font></FONT><font face="Arial" size="2" color="#FFFFFF">College 
                Expenses</font></STRONG></font></P>
            </DIV>
          </TD>
        </TR>
        <TR align="middle"> 
          <TD align="left" bgcolor="white" colspan="2" height="18" width="663"> 
            <center>
              <p>
              <FONT face="Arial" size="1"><font color="#330099"><font color="#003300"></font></font></FONT> 
              </p>
            </center>
          </TD>
        </TR>
        <TR align="middle"> 
          <TD align="middle" colspan="2" height="213" width="663"> 
            <DIV align="center"> 
              <CENTER>
                <TABLE width="602">
                  <TBODY> 
                  <TR> 
                    <TD width="596"> 
                      <DIV align="center"> 
                        <CENTER>
                          <TABLE border="1" bordercolor="#333300" cellspacing="1" width="575">
                            <TBODY> 
                            <TR bordercolor="#FFFFFF"> 
                              <TD align="middle" bgcolor="#FF0000" width="33">
                              <font color="#FFFFFF"><SMALL><FONT 
                  face=Arial>Child:</FONT></SMALL></font></TD>
                              <TD align="middle" bgcolor="#FF0000" width="109">
                              <font color="#FFFFFF" face="Arial"><SMALL>Monthly 
                                child cost:</SMALL></font></TD>
                              <TD align="middle" bgcolor="#FF0000" width="179">
                              <font color="#FFFFFF" face="Arial"><SMALL>Years 
                                child will require support:</SMALL></font></TD>
                              <TD align="middle" bgcolor="#FF0000" width="231">
                              <font color="#FFFFFF" face="Arial"><SMALL>College 
                                expenses:</SMALL></font></TD>
                            </TR>
                            <TR bordercolor="#FFFFFF"> 
                              <TD align="middle" bgcolor="#C8D8FB" width="33"><font color="#333300" face="Arial"><SMALL>1 
                                </SMALL></font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="109"><font color="#333300" face="Arial"><SMALL>$</SMALL> 
                                <INPUT name=monthly 
                  onchange=AddIt(); size=7 value=0>
                                </font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="179"><font color="#333300"><SMALL><FONT face=Arial> 
                                <INPUT maxlength="2"
                  name=years onchange=AddIt(); size=4 value=0>
                                years</FONT></SMALL></font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="231"><font color="#333300" face="Times New Roman, Times, serif"> 
                                <INPUT maxlength="15" 
                  name=collexp onchange=AddIt(); size=10 value=0>
                                </font></TD>
                            </TR>
                            <TR bordercolor="#FFFFFF"> 
                              <TD align="middle" bgcolor="#C8D8FB" width="33"><font color="#333300" face="Arial"><SMALL>2</SMALL></font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="109"><font color="#333300" face="Arial"><SMALL>$</SMALL></font><font color="#333300" face="Times New Roman, Times, serif"> 
                                <INPUT name=monthly2 
                  onchange=AddIt(); size=7 value=0>
                                </font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="179"><font color="#333300"><SMALL><FONT face="Arial"> 
                                <INPUT maxlength="2" 
                  name=years2 onchange=AddIt(); size=4 value=0>
                                years</FONT></SMALL></font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="231"><font color="#333300" face="Times New Roman, Times, serif"> 
                                <INPUT maxlength="15" 
                  name=collexp2 onchange=AddIt(); size=10 value=0>
                                </font></TD>
                            </TR>
                            <TR bordercolor="#FFFFFF"> 
                              <TD align="middle" bgcolor="#C8D8FB" width="33"><font color="#333300" face="Arial"><SMALL>3</SMALL></font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="109"><font color="#333300" face="Arial"><SMALL>$</SMALL></font><font color="#333300" face="Times New Roman, Times, serif"> 
                                <INPUT name=monthly3 
                  onchange=AddIt(); size=7 value=0>
                                </font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="179"><font color="#333300"><SMALL><FONT face="Arial"> 
                                <INPUT maxlength="2" 
                  name=years3 onchange=AddIt(); size=4 value=0>
                                years</FONT></SMALL></font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="231"><font color="#333300" face="Times New Roman, Times, serif"> 
                                <INPUT maxlength="15" 
                  name=collexp3 onchange=AddIt(); size=10 value=0>
                                </font></TD>
                            </TR>
                            <TR bordercolor="#FFFFFF"> 
                              <TD align="middle" bgcolor="#C8D8FB" width="33"><font color="#333300" face="Arial"><SMALL>4</SMALL></font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="109"><font color="#333300" face="Arial"><SMALL>$</SMALL></font><font color="#333300" face="Times New Roman, Times, serif"> 
                                <INPUT name=monthly4 
                  onchange=AddIt(); size=7 value=0>
                                </font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="179"><font color="#333300"><SMALL><FONT face="Arial"> 
                                <INPUT maxlength="2" 
                  name=years4 onchange=AddIt(); size=4 value=0>
                                years</FONT></SMALL></font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="231"><font color="#333300" face="Times New Roman, Times, serif"> 
                                <INPUT maxlength="15" 
                  name=collexp4 onchange=AddIt(); size=10 value=0>
                                </font></TD>
                            </TR>
                            <TR bordercolor="#FFFFFF"> 
                              <TD align="middle" bgcolor="#C8D8FB" width="33"><font color="#333300" face="Arial"><SMALL>5</SMALL></font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="109"><font color="#333300" face="Arial"><SMALL>$</SMALL></font><font color="#333300" face="Times New Roman, Times, serif"> 
                                <INPUT name=monthly5 
                  onchange=AddIt(); size=7 value=0>
                                </font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="179"><font color="#333300"><SMALL><FONT face="Arial"> 
                                <INPUT maxlength="2" 
                  name=years5 onchange=AddIt(); size=4 value=0>
                                years</FONT></SMALL></font></TD>
                              <TD align="middle" bgcolor="#C8D8FB" width="231"><font color="#333300" face="Times New Roman, Times, serif"> 
                                <INPUT maxlength="15" 
                  name=collexp5 onchange=AddIt(); size=10 
              value=0>
                                </font></TD>
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          <TD align="middle" bgcolor="#0000FF" colspan="2" height="25" width="663"> 
            <DIV align="left"><FONT color="#FFFFFF" face="Arial"> 
              <P><SMALL><B> Recommended Additional Life 
                Insurance:</B> <B>$</B></SMALL> 
                <INPUT name=insrecom onclick=AddIt(); 
  size=20> </P>
              </FONT></DIV>
          </TD>
        </TR>
        </TBODY> 
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<nobr>|<a href="gpage4.html">RESP</A>|</nobr>

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