Final Expense
Date of Birth
LIFE-STYLE®
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
Gender
Male
Female
Tobacco Status
Non-Tobacco
Tobacco
Face Amount
$3,000
$4,000
$5,000
$6,000
$7,000
$8,000
$9,000
$10,000
$11,000
$12,000
$13,000
$14,000
$15,000
$16,000
$17,000
$18,000
$19,000
$20,000
$21,000
$22,000
$23,000
$24,000
$25,000
$26,000
$27,000
$28,000
$29,000
$30,000
$31,000
$32,000
$33,000
$34,000
$35,000
Mode
Monthly
Semi-Annual
Annual
Is this a Washington Quote?
No
Yes