BROKERAGE

Quote Forms

Quote Form Instructions

Please select, download and fill out the the appropriate forms. Print and fax or attach the form to email to:

Life Insurance Proposal Request Form
Aaron at 602-956-7711 fax
email

Disability Income Insurance Proposal Request Form
Kirk at 602-957-0566 fax
email

Forms for Download

Quote for DI

Quote for Life



John Driscoll and Company, Inc. is licensed to sell insurance in AZ. The information on this site is intended for the residents of Arizona. The Financial Representatives of John Driscoll and Company, Inc. are not licensed to sell insurance in all 50 states. To find out if an agent is licensed in your state, please contact Cindy Driscoll at 602-957-7155 (voice) or 1-800-354-3778 (toll free).

Neither Park Avenue Securities nor The Guardian Life Insurance Company of America provide tax or legal advice, please consult your advisors regarding your specific situation.

Guardian does not offer individual health products.

Securities products/services and advisory services are offered through Park Avenue Securities LLC (PAS), 5050 N. 40th Street, Suite 350, Phoenix, AZ 85018, (602) 957-7155. PAS is a registered broker-dealer and investment adviser. PAS is an indirect wholly-owned subsidiary of The Guardian Life Insurance Company of America, New York, NY.

PAS is a member FINRA, SIPC.