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Ghton - 2041 SECTION 1 OR OR VALIDATION AND CONFIRMATION I, , the claimant on this policy, confirm that I have (i) Read, (ii) understand, (iii) agree, (iv) and will adhere to the requirements noted as Section 1, which is outlined on the original faxed cover sheet submitted to me by HOLLARD, which lists the requirements of the claim. (Note that the first page of the fax is not to be faxed with the claim form and required documents. Should you not agree to any of the noted points, please highl.

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