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Department of Insurance <br />State of Indiana <br />q W! P; <br />Whereas, COMPj <br />requiremen WUS M <br />0 <br />Indiana. <br />Therefore; as mnce <br />authorize, emp rand '4 <br />- kiwi <br />Class 11 (b) dtftLj' <br />Class III (a) (C) <br />through its duly aud"ked agents Ila <br />appikable to said Company. <br />NAIC# 14788 <br />UA <br />010 <br />VOW <br />qY of Jac IM�1110, IPt 11 the <br />Ins6ance. wexoyh le of <br />to na, me by I do hereby <br />Sect d6p of., <br />lance thereof which are <br />M TES77MONY WHEREOF I hereunto <br />subscrnibe pmname and affix the seat of my <br />office the to Hftn above. <br />