DECLARATIONS. By accepting this policy, you agree that all the statements in your application and the declarations are true and that you have provided us with all material information about your pet’s health. You agree that this policy and any endorsements or riders issued to you is the entire and only agreement between you and us.
DECLARATIONS. To make possible the fullest attainment of the above-stated objective, the following declarations shall apply:
DECLARATIONS. 1. Each State Party shall submit to the Secretary-General of the United Nations, not later than 30 days after this Treaty enters into force for that State Party, a declaration in which it shall:
DECLARATIONS. Each of the undersigned declares, understands and agrees that: - The answers provided above are complete and true to the best of his/her knowledge and belief. - If the answers to the Health Questions contained in this Agreement or the Application are incorrect, incomplete or untrue, the Company will have the right to deny benefits under this Agreement. X Date: ----------------------------------- ------------------------------ Proposed Primary Insured Signature X Date: ----------------------------------- ------------------------------ Proposed Policy Owner Signature (if other than the Proposed Insured) RECEIPT OF PAYMENT A premium payment of $ has been submitted with the Application or Request. Additional premium may be required upon Policy delivery. All premium checks must be made payable to Hartford Life Insurance Company or Hartford Life and Annuity Insurance Company. Do not make check(s) payable to the Agent or leave the payee blank. X Date: ----------------------------------- ------------------------------ Agent Signature DETACH OWNER'S COPY AT TIME OF APPLICATION HOME OFFICE COPY Allocated Retention. Pool -- Effective 10/1/2008 Between HLIC and TFLIC EXHIBIT VI CONDITIONAL RECEIPT OR TEMPORARY INSURANCE AGREEMENT EFFECTIVE OCTOBER 1, 2008 [LOGO] HARTFORD LIFE INSURANCE COMPANY THE HARTFORD HARTFORD LIFE AND ANNUITY INSURANCE COMPANY 500 BIELENBERG DRXXX, XXXXXXXX, XX 55125 P.O. BOX 64271, ST. PAUL, MN 55164-0200 TEMPORARY INSURANCE AGREEMENT PROPOSED PRIMARY INSURED: NAME: DATE OF BIRTH: Under this Temporary Insurance Agreement ("Agreement"), Hartford Life Insurance Company or Hartford Life and Annuity Insurance Company ("Company") agrees to provide a limited amount of life insurance coverage, for a limited period of time, subject to the terms and conditions set forth below. WHEN COVERAGE BEGINS Temporary life insurance coverage under the Agreement becomes effective on the date this Agreement is signed, subject to ALL of the following conditions:
DECLARATIONS. Each of the undersigned declares, understands and agrees that: - The answers provided above are complete and true to the best of his/her knowledge and belief. - If the answers to the Health Questions contained in this Agreement or the Application are incorrect, incomplete or untrue, the Company will have the right to deny benefits under this Agreement. X Date: ----------------------------------- ------------------------------ Proposed Primary Insured Signature X Date: ----------------------------------- ------------------------------ Proposed Policy Owner Signature (if other than the Proposed Insured) RECEIPT OF PAYMENT A premium payment of $ has been submitted with the Application or Request. Additional premium may be required upon Policy delivery. All premium checks must be made payable to Hartford Life Insurance Company or Hartford Life and Annuity Insurance Company. Do not make check(s) payable to the Agent or leave the payee blank. X Date: ----------------------------------- ------------------------------ Agent Signature OWNER'S COPY Allocated Retention Pool (Excess Risks) -- Effective October 1, 2008 Between HLIC and Canada Life 104 EXHIBIT VII REINSURANCE REPORTS EFFECTIVE OCTOBER 1, 2008
DECLARATIONS. I, the Assured, understand, agree, and declare that: Apart from minor ailments I have not received any treatment during the past 12 months or been hospitalized or undergone hospital treatment or specialist investigation during the past two years and have never suffered from any form of disability or heart disease, stroke, cancer, kidney disease or HIV/ Aids-related condition. If you are unable to make this declaration, please provide full detail in the space provided below: My attention has been drawn to the fact that a pre-existing medical condition may invalidate a claim under this Policy. Any doctor, other person or institution is authorized before and after my death to disclose any information concerning my health, including the results of any blood tests, to the Insurer. I understand and accept that my right to privacy may be infringed to the extent permitted by me in this authorization, and I hereby waive such right to that extent. I understand that the Insurer reserves the right to defer or decline a claim on any life assured covered by this Policy, should the Insurer find any information material to risk provided on the application to be false or incomplete. Should circumstances change so that my answers are no longer valid, this information shall be forwarded to the Lender. I understand that failure to do so may invalidate cover. I hereby cede, transfer, assign and make overall my right, title, and interest in this Policy in so far as the Death Benefit and the Total Permanent Disability Benefit, as collateral security for the Agreement to the Lender All the information supplied in connection with this Policy, whether in my own handwriting or not, is true and complete and will form the basis of the Policy. I am aware that the Insurer underwrites this Policy. FREEDOM OF CHOICE DECLARATION The Lender requires that the Assured maintains a credit life insurance policy in place for the duration of the Agreement. The Assured has the option to select this Policy, which is administered by the Lender, or to offer an alternative policy that meets the minimum regulatory requirements. If the Assured offers an alternative credit life insurance policy, it must be approved by the Lender. The choice by the Assured to offer such an alternative credit life insurance policy will suspend the Loan application process until the alternative policy has been approved by and ceded to the Lender. This can take between 5 and 20 working days. Whether option 1) or 2) above is c...
DECLARATIONS. If requested by Landlord at any time during the Term, Tenant promptly will execute a declaration in the form attached hereto as Exhibit B.
DECLARATIONS. 4.1. In case the Customer is an individual who signs the mandate as the Customer’s representative also personally provides the declarations, confirmations and guarantees of the Customer and is personally bound due to this. He also declares that he has full authority to contract and perform FX Transactions, has received the required authorizations and has proceeded with all the actions that are necessary for the undertaking and the fulfillment of the obligations under the FX Transactions Terms.
DECLARATIONS. The Declarations to this Agreement shall form an integral part of this Agreement.
DECLARATIONS. In signing this Agreement and taking entry to the Let Property, the Tenant confirms that he or she: • has made full and true disclosure of all information sought by the Landlord or Letting Agent in connection with the granting of this tenancy • has not knowingly or carelessly made any false or misleading statements (whether written or oral) which might affect the Landlord's decision to grant the tenancy. • read and understood all of the terms of this Agreement including the accompanying legal commentary. Tenant 1 Signature Tenant Full Name (Block Capitals) Tenant Address Date: Tenant 2 Signature Tenant Full Name (Block Capitals) Tenant Address Date: Tenant 3 Signature Tenant Full Name (Block Capitals) Tenant Address Date: Tenant 4 Signature Tenant Full Name (Block Capitals) Tenant Address Date: Tenant 5 Signature Tenant Full Name (Block Capitals) Tenant Address Date: Landlord Signature Landlord Full Name (Block Capitals) Landlord Address Date: Landlord Signature Landlord Full Name (Block Capitals) Landlord Address Date:
