J.A. MESSINA INSURANCE Presents:

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Affiliated with So. Florida’s superior Medicare HMO organizations:

  • CarePlus Healthplans,
         Inc.
  • Humana Medical Plan,
         Inc,
  • Vista Healthplan, Inc.


    Thanks for using our services!

    © 2004 J.A. MESSINA INSURANCE
    PO Box 244571
    Boynton Beach, FL 33424-4571
    Phone: 561-736-2162
    Fax: 561-736-0228
    License#A177282

    E-Mail us at:
    jamessinains@comcast.net

    For Your Convenience,
    We gladly accept:


    "All Our Policies Come With
    an Agent!"

  •  
    Need Coverage TODAY? After Submitting
    Your Quote Form (see below), Call Toll-Free:
    1-800-735-2162

    Phone quote hours are Monday-Friday
    (9:00am-5:00pm Florida local time).

    Free Life Insurance Analysis

    Need security for a certain period of time, for example to cover an Outstanding loan/debt/obligation? How about the coverage to provide the necessary funds for the maintenance, including a guaranteed education for the children?

    Term insurance is the answer - a large amount of life insurance at the lowest possible cost. Remember, money only pays for the insurance... good health buys it!

    Consider the purchase NOW while you do enjoy good health. Let us assist you in determining what’s RIGHT for you by providing the information requested below. We will respond with out finding within 24 hours!

     
    FREE Life Insurance
    Analysis Request Form
    One Simple Form - takes only 2-3 Minutes!


    Your Personal Data

    Your Name:
    Street Address:
    City:
    Your "County" is?
    State: MUST be Florida!
    Zip Code:
    E-Mail (REQUIRED):
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    Phone:
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    Marital Status:
    Single Married
    Are You Retired?
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    List any health problems and medication taken:
     
    Compared to others in your age group, which best describes your general health? Excellent
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    What is Your Birthdate?
     
    What is Your Spouse's Birthdate?
     
    List your children's ages:
     
    What is your total outstanding debt?
    $
     
    Send my free Life Analysis via: E-Mail Fax
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    Thank you for filling out this form COMPLETELY!

    We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

    Yes, I Agree. Please Send Me My Free
    Life Insurance Analysis NOW!


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