GROUP HEALTH INSURANCE QUOTE MORE EMPLOYEES
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Company Name:
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EMPLOYEE INFORMATION
DATE OF NUMBER OF CHILDREN COBRA HOME ZIP CODE
LAST NAME FIRST NAME M/F BIRTH SPOUSE
INSURANCE & ANNUITIES
RETIREMENT
EMPLOYEE BENEFIT PLANS
WEALTH PRESERVATION
BUSINESS PLANNING
REVERSE MORTGAGES
*"PartTime" means that the employee works less than 1,000 hours per year. List "Ownership Perecnt " of all Owners. State family relationships to Owner(s) such as spouse, child, parent etc.
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Mendonca Insurance Services
949.954.4445
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Insurance
Annuities
Retirement Income
Tax Avoidance Strategies
Your INDEPENDENT Resource
949.954.4445
[email protected]
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