Insurance certification

Insurance certification - Homeowners Insurance Name of Ins....

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INSURANCE CERTIFICATION IN LIEU OF ADDIFAVIT PURSUANT TO R. 5:4-4(f) I certify pursuant to R. 5:4-2(f), the following insurance policies: Life Insurance Name of Ins. Company: Policy No: Name of Insured: Other Persons Covered: Amount of Coverage: Policy Term: Named Beneficiaries: Health Insurance: Name of Ins. Company: Policy No: Name of Insured: Other Persons Covered: Description of Terms: Automobile Insurance Name of Ins. Company: Policy No: Name of Insured: Other Persons Covered:
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Unformatted text preview: Homeowners Insurance Name of Ins. Company: Policy No: Name of Insured: Other Persons Covered: The following insurance coverage was cancelled or modified within the last 90 days and a description of the cancelled insurance coverage is as follows: I certify that the foregoing statements made by me are true. I am aware that if any of the documents are willfully false, I am subject to punishment. _________________________________ Dated:...
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This note was uploaded on 05/06/2008 for the course REAL 101 taught by Professor Davis during the Spring '08 term at Fairleigh Dickinson.

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