Final Expenses Needs Analysis Helps eliminate the Financial Burden associated with death Funeral Merchandise $ 3000 Vault, Casket, Urn Flowers, Hearse $ 1000 Funeral Service $ 2100 Embalming, Viewing Cemetery Charges $ 400 Plot, Opening/Closing Monthly rent $____________ $______X___months Light & Water bill $____________ $______X___months Food Expense $____________ $______X___months Unpaid bills $____________ Total needed for $____________ Final Expenses

Things you should know #1 Social Security pays only $255 as a benefit and only to qualified dependents The VA final expense benefit is only $300 if one qualifies An household Social Security income can be cut by as much as 50% with the death of a spouse ----------------------------------------------------------------------------------------------------------------------------------------------------- #1 Insured:__________________________ age:____ Prem$__________ Natural Death: $________________ Accidental Death: $________________ Common Carrier Death:$________________ Cash and Loan values: Yes Waiver of Prem: Yes__No__ Accidental Loss of Limb: Yes__No__ ------------------------------------------------------------------------------------------------------------------------------------------------------ #2 Insured:__________________________ age:____ Prem$__________ #3 ------------------------------------------------------------------------------------------------------------- Child Rider Benefit: $____________on ea. Child Prem$_________ Issue ages 0-17 (till age 22) Total $__________ Not Binding – Illustration Only