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Get Application Formhdb Basic Fire Insurance

Applicant s Instructions: 1. Answer all questions 2. If space is insufficient to answer any questions fully, attach separate sheet. 3. Application must be signed and dated by department manager or above. 4. If the answer to any question is none, state NONE . 1. APPLICANT a) b) c) Full Name Principal address Subsidiaries or Divisions d) You are : Sole venture Manufacturer Exporter Joint venture Wholesaler Other Retailer e) f) Years in business under present name Prior experience.

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