Times in Hammond, Indiana
30 Mar 1974

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Times in Hammond, Indiana
30 Mar 1974

Read an issue on 30 Mar 1974 in Hammond, Indiana and find what was happening, who was there, and other important and exciting news from the times. You can also check out other issues in The Times.

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Times (Newspaper) - March 30, 1974, Hammond, IndianaAct now. Mail your application today during this acceptance period. Its so easy to apply a please Check the Block for either plan a or plan b. See Page 3 for rates. A you must fill out completely. Incomplete applications will cause a delay in issuing your policy. A fill out the first Section for yourself. A if you Are including dependents fill out the second Section completely for each name. A sign and Date the application at the Bottom. A enclose the application with $1 for the first month s coverage in the postage paid envelope and mail it today. 1. 2.accident and health application form v please Check the amount of Cash you wish a plan a a plan $40.00 a Day $280.00 a week $1200.00 a month $20.00 a Day $140.00 a week $600.00 a month 102097 6 102102 6 official application form to Union Fidelity life insurance company Trevose Pennsylvania please print or. Name mrs. Miss first Middle initial last address Street or . No. City state zip Date of birth age month Day year sex a la male q female list All dependents to be covered under this plan do not include a me that appears above. Use separate Sheet if necessary name please print relation ship sex Date of birth age month Day year 1. 2. 3. 4. 5. I Check Here if you want coverage for your children. I hereby apply for Union Fidelity a Hospital benefits policy to cover myself and All other persons listed above. T o the Best of my knowledge and belief neither i nor any other person listed above has been refused or had cancelled any health Hospital or life insurance policy because of reasons of health. I understand that new conditions will be covered immediately and that diseases or physical conditions which any covered person now has or has had in the past will not be covered until my policy has been in Force for one year. Signature sign a do not print Date 02209-33-9you Deal direct. No agent will Call Page 4

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