Diaz Insurance Agency
Office: 203-866-1133
E-mail: Email Us





























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Your Full Name (Su Nombre Completo):

 

E-mail address to send information
(Dirección de Email donde mandar informacion):

  Date of Birth (Fecha de Nacimiento):
  Spouse Full Name
Nombre Completo de Esposo(a):
  Date of Birth (Fecha de Nacimiento):
  Street Address (Dirección):
  City (Cuidad):
  State (Estado):
  Zip (Código Postal):
  County (Condado):
  Phone number where you would like to be contacted (Teléfono donde quisiera ser contactado):
  Best time to reach you? (Cual es la mejor hora para contactarlo?)
 

Do you own your own home, or do you rent?
(Usted es dueño de su propia casa o renta?)

 

Is this a condominium or townhouse unit
(Es un condómino o townhouse):



  We offer the following types of insurance products for your family's insurance needs
(Ofrecemos los siguientes clases de productos de seguro para las necesidades de familia):
 

Life Insurance

Term Life -- Level term plans with 5, 10, and 20 year guarantees.

Decreasing Term -- To help pay off your home mortgage.
                            (Para ayudar a pagar la hipoteca de casa.)

Annual Renewal Term -- For short term, immediate needs. (Para corto plazo, necesidad inmediata)

Universal Life -- Flexible secure with money market interest rates.
                       (Flexible seguro con money market tasas de interes.)

Traditional Whole Life -- Guaranteed interest on your cash values.
                                   (Interés garantizado en sus valores de efectivo)

Second to Die -- An excellent survivor policy for estate planning issues.
 


Annuities
Tax Sheltered Annuities, immediate, deferred or indexed annuity.

 
 
Long Term Care

Disability and Income Buyout Plans ( Planes de Deshabilitad y Income Buyout)
Individual and Group Health (Individual y Salud Grupo)

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