Request a Life Insurance Quote

For immediate quotes, call Dave Erickson at 805-639-3304.  If you prefer to request a quote on-line, please fill out the form below.  Quotes are returned the same business day, in most cases.

 

 

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Insurance Type
Period
Date of Birth
Insurance Coverage Amount
First Name
M.I.
Last Name
Mailing Address (no P.O. Boxes)
City
State
ZIP
Home Telephone
Work Telephone
Fax
Mobile / Pager
Email
Smoker
Non-Smoker
List Present Health Conditions
List Current Prescription Medications
Health Information

Coverage Information

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