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Photographic and Personal Statement Release

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I authorize Royal Neighbors of America to use my photograph and record my voice and likeness, whether by film, videotape, magnetic tape, digitally, or otherwise, for educational, informational, promotional, and/or advertising purposes, commercial or otherwise, through any type of media, including but not limited to television, newspapers, magazines, website, social media, or other vehicles as deemed appropriate.


I further understand that Royal Neighbors of America owns and/or is entitled to use the media in which my photograph, voice, or likeness is stored, and there will be no restrictions on the number of times it is used.




Signature:___________________________________________________________________________________   Date:___________________________________



As witnessed by:



________________________________________________________________
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Life-Insurance

a contract between an insurance policy holder and an insurer or assurer, where the insurer promises to pay a designated beneficiary a sum of money (the benefit) in exchange for a premium, upon the death of an insured person (often the policy holder).

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MY INSURANCE CALCULATIONS

The calculations contained within this calculator are specific to Royal Neighbors of America. It is intended to estimate an amount of life insurance coverage if death occurred in the near future. It is not a recommendation for specific coverage amounts. Your financial needs may differ from the estimates. Royal Neighbors does not guarantee that the amount illustrated here will meet your financial needs. You are responsible for selecting the appropriate amount of coverage. To evaluate your specific needs, please contact Royal Neighbors directly at (866) 845-6665.

Needs
  • Immediate Needs N/A
  • Mortgage Amount: N/A
    Other Debts: N/A
    Funeral Expenses:N/A
  • Long-term Needs N/A
  • College Costs: N/A
    Total Income:N/A
  • Total Needs N/A
Resources
  • Immediate Resources N/A
  • Investment Assets N/A
    Life Insurance Proceeds N/A
  • Long-term Resources N/A
  • Partner's Earnings N/A
    Social Security N/A
  • Total Resources N/A
 
Additional Life Insurance Needed
  • Your total needs minus your total resources means you need N/A

Income Replacement Estimate

This chart estimates how much life insurance your loved ones may need to replace your income and maintain their current standard of living. Your dependents may be eligible to collect Social Security income benefits, which are included in the calculation below. The “Insurance Needed” column does not include financial needs such as paying off debt or paying for college.
Year Partner Age Partner Income S.S. Income Available Income Desired Income Surplus/Shortfall Available Resources Insurance Needed

Calculations include your answers to the previous questions, in addition to the following: 3% investment return; 2.6% anticipated inflation rate; $8,500 for funeral expenses which is based on the national median cost for an adult funeral in 2014 according to the National Funeral Directors Association1; 75% of your annual combined income for desired annual income needs; and 15 years for the number of years’ income needed or the calculation of the number of years it will take your youngest child to complete higher education, whichever is greater. Social Security benefits were factored based on the age of your youngest children (up to 4). Immediate needs include your mortgage, other debts, and $8,500 for funeral expenses.

College cost estimates are based on the following parameters (based on data provided by [College Board] . The inflation rate for college costs (5.48% annually) is based on the Bureau of Labor and Statistics Consumer Pricing Index average from January 1996-June 2016. This rate will factor into college cost assumptions for future years, adjusted annually.

  • Amount for community college: 2 years @ $3,435/year (tuition and fees only)
  • Amount for public university: 4 years @ $19,548/year (tuition, fees, room and board)
  • Amount for private university: 4 years @ $43,921/year (tuition, fees, room and board)

1 “The national median cost of a funeral with viewing and burial for calendar year 2014 was $7,181. If a vault is included, something that is typically required by a cemetery, the median cost is $8,508. The cost does not take into account cemetery, monument or marker costs or miscellaneous cash-advance charges, such as for flowers or an obituary.” http://www.nfda.org/news/statistics

 
The specified form no longer exists or is currently unpublished.
Form #: P00500; Rev. 7-2021