Disclaimer: By submitting your life insurance application you are agreeing to allow Charitable Life LLC to review the information and determine if it is appropriate to further submit your application to one or more insurance carriers that Charitable Life LLC represents. Each insurance carrier have their own rules and regulations that they follow to determine if they will provide a contract offer as well as how much coverage and at what price they may offer the coverage. This possible offer is then reviewed by Charitable Life LLC and presented to the owner of the contract for their final determination if it will accept the offer and at what level. If the owner of the contract accepts the offer and places the insurance in place, you will be so notified. Thus, authorizing Charitable Life LLC the right to review your initial application does not guarantee that you have been or nor will be accepted for life insurance. It should be further noted that completing this questionnaire is not a solicitation of insurance. Charitable Life LLC will review the information and determine if you qualify for possible submission. If it is determined that you do not resident in a State which Charitable Life LLC is licensed in, you will be immediately notified that your application is not eligible to see if it qualifies for participation at this time.
Name of the organization you are a Member of: Name of Ministry or Non-Profit Address of the organization you are a Member of: Street Address Address Line 2 City State Zip Contact Information of the organization you are a Member of: Email Area Code Phone Number This year I gave $ Dollars (USD) * and Hours * Hours per week to this charityLast year I gave $ Dollars (USD) * and Hours * Hours per week to this charityPrevious year I gave $ Dollars (USD) * and Hours * Hours per week to this charity
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