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I am a smoker (required) YesNo
Annual Salary Range (required to compute recommended life coverage) Please select...No incomeUp to 30k31k - 60k61k - 100k101k - 150k151k - 200k201k - 250kAbove 250k
Current Life Insurance Cover Notes (if more than 3 files, please email to info [at] mypf [dot] my)
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