• Home
  • Get A Quote
  • Customer Service
  • Refer a Friend
  • About Us
  • Location Map
  • Employee Directory
  • Privacy Policy
  • Contact Us
Call Us
Call Us Today |
(888) 513-8784
Home

In Omnia Paratus…"Ready for all things!"


blue referral button
  • Home
  • Get A Quote
  • Customer Service
  • What We Offer
    • Auto Insurance
    • Boat & Watercraft
    • Business Owner's Policy
    • Commercial Auto
    • General Liability
    • Home Insurance
    • Life Insurance
    • Pet Insurance
    • Product Liability
    • Workers Compensation
  • Blog
  • Make a Payment
  • Resources
    • Risk Management Center Login
    • Refer a Friend
    • Important Links
    • Insurance Glossary
  • About Us
    • About First Independent - Descamps Insurance Agency
    • Our Locations
    • Testimonials
    • Privacy Policy
  • Contact
    • Contact Us
    • Join Our Newsletter
Auto Insurance AUTO
INSURANCE
Read More
Boat Insurance BOAT &
WATERCRAFT
Read More
Business Insurance BUSINESS
INSURANCE
Read More
Homeowners Insurance HOME
INSURANCE
Read More
Life Insurance LIFE
INSURANCE
Read More
Other Insurance OTHER
INSURANCE
Read More
Home > Life > Request Declaration and Coverages Page for Existing Life Insurance Coverage
Secured by SSL

Request Declaration and Coverages Page for Existing Life Insurance Coverage


Fill out the following form as completely as possible. Once you have completed the form, click Submit to send your information to First Independent Insurance Agency . We will handle your request shortly.

Please note: Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company.


Personal Information
First Name *
Last Name *
Street *
City *
State *
ZIP / Postal Code *
Primary Phone Number *
Alternate Phone Number
E-Mail Address *
Policy Information
Policy Number *
Submission Validation
Required

Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
Secured by SSL
Insurance Websites Designed and Hosted by Insurance Website Builder
Facebook
Twitter
LinkedIn
Fremont
EMC
Pioneer State Mutual
Frankenmuth
Mainstreet
Michigan Insurance
Nationwide
Chubb
elephant insurance logo
Twitter Logo

Resources

Home About Us Get a Quote Customer Service Newsletter Contact Us

Contact Us

map icon
  • Sterling Heights Office
  • 14500 Lakeside Circle
  • Sterling Heights, MI 48313
  • Phone: 586.247.2220
  • Fax: 586.247.7570
© Copyright. All rights reserved.
Powered by Insurance Website Builder