Sunday Gazette-Mail from Charleston, West Virginia on August 6, 1972 · Page 154
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Sunday Gazette-Mail from Charleston, West Virginia · Page 154

Charleston, West Virginia
Issue Date:
Sunday, August 6, 1972
Page 154
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Page 154 article text (OCR)

Advertisement OFFICIAL ENROLLMENT FORM APPLICATION TO NATIONAL-BEN FRANKLIN LIFE INSURANCE CORPORATION, CHICAGO, ILLINOIS Please Print YOUR NAME, Firs! Middle Initial Last .DATE OF BIRTH. ADDRESS. CITY (mo'/day/yr.) .SOCIAL SECURITY NO.. -AGE. .STATE. .ZIP CODE. Liu all dependents to be coveted. Use separate sheet for additional children. NAME (PLEASE PRINT) DATE OF BIRTH (mo/day/yr.) NAME (PLEASE PRINT) DATE OF BIRTH mo./day/yr.) I represent that neither I nor my spouse, if listed above, has been hospitalized due to sickness for a total of more than seven days in the last two years. I agree that if both husband and wife are covered, the husband will be the Insured. 1 understand that coverage wfll take effect when the policy is issued. .SIGNATURE. DATE 4801 NBL Please make check or money order payabk to N-Bf Life. Tbj» Policy Serin C4?«7 it available !· all tutn wftn* aoptwM by tkc i 4088 i resident* pleat* mail ·nrollnwit form to E. E. Rlvtr», A«nt, P.O. Box 2475. Pvntacola. Florid* 33054 · DETACH AND KEEP WITH YOUR RECORDS Fill Out and Mail No-Risk Enrollment by Aug. 29th with only H°° to NATIONAL-BEN FRANKLIN LIFE D«pL4088 380 West Jackson Blvd. Chicago, III. 60606 ©cic YOUR-*1-BACK NO-RISK GUARANTEE If after reading your EXTRA CASH/PLUS POLICY and showing it son-return the policy within 10 days of receipt and your $1 will to a family advisor you feel it does not fit your needs for any rea- be refunded promptly. There is no further obligation. National-Ben Franklin Life Insurance Corporation IS A MEMBER OF Hie Continental Corporation Established 1852 PARADE · AUGUST 6, 1972

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