Full Name:          
Mailing Address:
City:
State:  South Carolina
Zip Code:
Email Address: (Required) 
Home Phone:   Work Phone:   Ext.
How to Contact You:       Cell Phone:
Date of Birth:              (mm/dd/yyyy)
Gender:    Height:  ft. 
Weight:    Do you smoke?

Do you currently have life insurance?   
Type of life insurance currently owned:
Current Premium:$  per month

Who will be insured:                     
Type of life insurance desired:       
Amount of Life Insurance Desired:    Other Amount:$ 
Benefit Period Desired:                 

Has anyone to be insured had health problems during the past 10 years
or been diagnosed with a serious illness?
If "Yes", please list information below.


Does anyone to be insured have a hazardous job? Yes No
Is anyone to be insured an active member of the military reserves? Yes No

Additional Comments or Requests



Click on the "Submit Quote Request" button below
to send your Life Insurance quote request.**


**Information received from this Life Insurance quote request form sent to Russell-Massey & Company will be for our use only and will not be sold, given to or distributed to any other parties. A quote will be based on the life insurance policy information provided and does not guarantee acceptance of the risk by us. The precise coverage afforded is subject to meeting underwriting guidelines, and the terms, conditions and exclusions of the policy as issued. By submitting this request you acknowledge that this is neither an offer to insure nor a guarantee of insurance. Completion of this form does not entitle you to a South Carolina Life Insurance policy. We are licensed in South Carolina and will not provide life insurance quotes for other states.


We are a Columbia, SC insurance agency offering affordable South
Carolina life insurance policy quotes in the following towns, cities
and counties in South Carolina: Chapin, Arthurtown, Saluda
Terrace, Sandwood, Arcadia Lakes, Cayce, Olympia, Forest Acres,
Dentsville, Eau Claire, West Columbia, Springdale, Denny Terrace,
Belmont, St. Andrews, Irmo, Oak Grove, Lexington, Galaxy, Bluff
Estates, Hazelwood Acres, State Park, Haskell Heights,
Lincolnshire, Ballentine, Killian, Red Bank, South Congaree,
Edmund, Gilbert, Summit, Gaston, Hopkins, Capitol View, Horrel
Hill, Fort Jackson, Pontiac, Elgin, Blythewood, Camden, Richtex,
Whitehall, White Rock, Sumter, Lugoff, Boykin, Rembert, Hagood,
Horatio, Stateburg, Borden, Wedgefield, Oswego, Gadsden, Fort
Motte, St. Matthews, Swansea, Woodford, Winnsboro, Pelion,
Steedman, Samaria, Monetta, Batesburg-Leesville, Stoney Hill,
Prosperity, Newberry, Peak, Little Mountain, Slighs, Pomaria,
Jenkinsville, Rion, Winnsboro Mills, Simpson, Smallwood,
Ridgeway, Orangeburg, Lexington County, Fairfield County,
Calhoun County, Sumter County, Kershaw County, Saluda County,
and Richland County, SC. We can also offer cheap South Carolina
life insurance premium quotes throughout the Palmetto state,
including in Florence, Greenville, Spartanburg, Myrtle Beach, and
Charleston, SC.
Life Insurance Quote
South Carolina
Applicant Information:
Your South Carolina
Life Insurance
Quote Source
Russell-Massey & Co.
1320 Elmwood Avenue
Columbia, SC 29201
Richland County, SC
Toll Free: (800) 849-7475
Office: (803) 779-7854
Fax: (803) 799-6546
Russell-Massey & Co.
409 Lexington Avenue
Chapin, SC 29036
Lexington County, SC
Office: (803) 941-3650
Fax: (803) 941-3654
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Russell-Massey & Co.
of Columbia, SC offers
affordable and
experienced personal
insurance coverage
services throughout
South Carolina.
Contact us about South
Carolina Auto, Renters,
Homeowners, Boat,
Motorcycle, Disability,
and Health Insurance toll
free at (800) 849-7475.
In addition to lower cost
South Carolina Life
Insurance, we also offer
affordable Health
Insurance policy
premiums.
South Carolina
Personal
Insurance Quotes
Life Insurance
Quote
Russell-Massey
& Company, Inc.
General Insurance
South Carolina Life Insurance Quotes!
800-849-7475 toll free
803-779-7854
Serving South Carolina Since 1955
South Carolina Homeowner Insurance
Click below to receive an INSTANT life insurance
quote as well as APPLY for coverage!
Richland County & Lexington County, SC Area
Richland County & Lexington County, SC Area