Insured Signature definition

Insured Signature. Date: Bank Account Holder’s Signature: Date:
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Examples of Insured Signature in a sentence

  • 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.

  • 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.

  • Accepted by SAMPLE POLICY Named Insured Signature This endorsement is a part of the policy.

  • Signature of Insured Signature of Agent or Broker Title Date Title Date Security Interest.

  • 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.

  • Insured Name (Printed) Insured Signature Date PURSUANT TO 28 U.S.C. § 1746 I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE UNITED STATES OF AMERICA THAT THE FOREGOING IS TRUE AND CORRECT.

  • SAMPLE POLICY Accepted by Named Insured Signature This endorsement is a part of the policy.