Please fill out the form below if you would like to be contacted in
regards to ANY insurance policy.  Specific quotes and requests,
fill out the forms at the bottom of page.
Contact Us
Your name:
Your email address:
Your phone number:
Comments:
Your name:
Your address:
Your phone number:
Date of birth:
Height/Weight
Smoker? How Long?
Amount of Insurance
you would like?
Please provide current medical history, include any
Prescription medication you are taking.
Do you want Term Insurance? If yes, please provide
the Number of years you would like
to be covered; i.e. 10, 15, 20 or 30 years.
Do you want Permanent Insurance?  
If yes, please specify if
You want Whole Life, Universal Life,
or Variable Universal Life.
For a FREE Insurance Quote, Fill Out The Form Below:
Your name:
Your phone number:
Best time to contact:
Comments:
FOR A FREE REVIEW AND EVALUATION OF
YOUR INSURANCE PORTFOLIO
Your name:
Your email address:
Your phone number:
Comments:
FOR A FREE CONSULTATION FOR SMALL
BUSINESS HEALTH PLANS
New Era Planning
347 Avenue X
Brooklyn, NY 11223

Phone:
718-336-4745
Toll Free:
866-947-9550
FAX:
718 336-5748
Email:
lifeinsurancesuperstore
@yahoo.com