Starmount Life 1-888-SAY-LIFE  (1-888-729-5433)(855) 235-5999  
Starmount Life Insurance - Protect Tommorrow...by Planning Today!
StarLife Gold
Term Life Insurance.

Protection to age 95 - your cost will not change due to age or health.*
Graphic Spacer Graphic Spacer Graphic Spacer Graphic Spacer Get a StarLife Gold Quote Now! StarLife Gold Plan Apply Now! Graphic Spacer

Graphic Spacer

 Basic Information

First Name  **
Last Name  **
Email  **
Policy Number  **
Home Phone  **


 Payment Information**

I want Starmount to deduct payments from my personal checking account automatically.

Bank Route #

Account #

Bank Name

Bank Location

OR
I want Starmount to deduct payments from my credit card automatically.

Card Type

Credit Card #

Expiration Date

/ (mm/yy)
I want to pay**
*** 5% Discount for annual payments


** Required Field
* Only if everyone in your classification has an increase will your cost ever increase. You cannot be singled out. Details may vary by state. Complete information will be provided with your policy.