Common use of Authorization and Agreement Clause in Contracts

Authorization and Agreement. The undersigned certifies that the information contained herein is true and complete to the best of its knowledge, information and belief. The undersigned further understands that failure to provide true and complete information may result in the denial of this request for appointment and/or subsequent termination thereof. The Agency and the undersigned authorize the Company to conduct an investigation concerning their qualifications for appointment including but not limited to its general reputation, and releases any person and/or companies contacted from all liability with respect to the information given. The Agency and the undersigned authorize the Company to investigate either of them now and at any time while the Agency or the undersigned is contracted with the Company and to share any information obtained with affiliated companies and Company management. Any such investigation may include obtaining one or more consumer reports (including credit scores/reports) from a consumer reporting agency. The undersigned expressly consents to the Company obtaining such reports at any such times. It is agreed that a photocopy of this authorization and release shall be as valid and binding as an original. Signature of Corporate Officer Date BROKER/DEALER AGENCY AGREEMENT WITH POWER TO APPOINT

Authorization and Agreement. The undersigned certifies that the information contained herein is true and complete to the best of its knowledge, information and belief. The undersigned further understands that failure to provide true and complete information may result in the denial of this request for appointment and/or subsequent termination thereof. The Agency and the undersigned authorize the Company to conduct an investigation concerning their qualifications for appointment including but not limited to its general reputation, and releases any person and/or companies contacted from all liability with respect to the information given. The Agency and the undersigned authorize the Company to investigate either of them now and at any time while the Agency or the undersigned is contracted with the Company and to share any information obtained with affiliated companies and Company management. Any such investigation may include obtaining one or more consumer reports (including credit scores/reports) from a consumer reporting agency. The undersigned expressly consents to the Company obtaining such reports at any such times. It is agreed that a photocopy of this authorization and release shall be as valid and binding as an original. Signature of Corporate Officer Date BROKER/DEALER AGENCY AGREEMENT WITH POWER TO APPOINTAPPOINT‌