Palffy Insurance Group

Business Continuation Information Request

Submit this request for information if you are interested in:
Key Person Insurance
Insured Buy-Sell Agreements
Business Loan Protection
Executive Benefits Plans

Information Request Form
*Required Fields

First Name*

Last Name*

Phone Number*

Email Address*

Select the types of business continuation planning that you are interested in.


An insurance agent will call you after you submit this form. The purpose of the call is to discuss your situation and to help us develop ideas and strategies to fulfill your needs. This is a complementary service with no obligation on your part.

We will also email you information specific to your request.

The information you provide will only be used for plan development and quoting purposes. Certain information will be shared with insurance companies for quoting purposes only. No insurance company and no other insurance agency will market to you as a result of submitting this form. We do not share your information with outside organizations for marketing purposes.