You may contact us anytime via phone or email, or by filling out  this info sheet.  We will make every effort to respond to your questions within 24 hours.
Lee Financial & Insurance Agency, Inc.
An Independent Agent
(405) 843-6427
We are licensed to serve Oklahoma

* This field can not be left  
   blank
 
Full Name *
Date of Birth*
Marital Status*
Home Address *
Phone #*
Best Time To Call
Fax #
Email*
Health Information
Height
Tobacco Use
Yes
 No
Weight
Any existing condition or illness?
* Note
Return Of Premium is optional benefit raider
provide a 100% refund of premium at the end
of the policy term. Even if you should cancel
your policy before the end of the policy term,
you may receive a partial refund of your
premium.
Select the product you like to
receive the free quote.
Face value / Amount Insured
Universal Life / whole Life
Term
Term Life Insurance
 Return Of Premium*
You can insure from $3000 to $25000
Final Expenses Life Insurance
Term
Mortgage Protection
 Death Benefit
Other raiders (Optional)
 Return Of Premium*
Comments, Questions, Information Requested:
Disability Income Benefit
Critical Illness
Waiver Of Premium
Accidental Death Benefit
Children's Term Benefit
Information About Yourself