Sunday Gazette-Mail from Charleston, West Virginia on September 10, 1972 · Page 159
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Sunday Gazette-Mail from Charleston, West Virginia · Page 159

Charleston, West Virginia
Issue Date:
Sunday, September 10, 1972
Page 159
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Page 159 article text (OCR)

$1 no-risk Money-Back Guarantee When you receive your policy, look it over at your convenience. If you wish, show it to a trusted advisor - even your own insurance man. And then, if you are not completely satisfied with your policy, return it to us within 30 days and we will promptly refund your money with no questions asked. Union Fidelity Life is licensed by the State of WEST VIRGINIA NO SALESMAN WILL CALL ACT NOW! THE EXPIRATION DATE OF MIDNIGHT Sept. 20,1972 WILL NOT BE EXTENDED. GET YOUR APPLICATION AND $1 IN THE MAIL TODAY. USE HANDY POSTAGE PAID ENVELOPE INSIDE. UNION FIDELITY LIFE INSURANCE COMPANY, a subsidiary of Union Fidelity Corporation Philadelphia, Pa. 19102. DON T FORGET; Check which Plan you wish to have |V I IIOOO.OOH MONIH D$500.00iMONTH 1 02110-13 OFFICIAL APPLICATION FORM TO: 5001 UNION FIDELITY LIFE INSURANCE COMPANY PHILADELPHIA. PENNSYLVANIA 44852 44853 44854 (Please Print) MR. Name MRS.. MISS Fint Middle Initial Lait (I* YOU are a married woman - u»e your own tint name). ADDRESS CITY S t r e e t or R D No STATE ZIP DATE OF BIRTH A G E . _SEX Male D Female D Month Day Year List all dependents to be covered under this Plan: (DO NOT include name that appears above. Use separate sheet if necessary.) NAME (Please Print) 1. 2. 3. 4. 5. RELATIONSHIP SEX DA MONTH TE OF Bl DAY RTH Y E A R AGE D Check here if you want Coverage for your Children. D Check here if you want Coverage for your Children and Maternity Benefits. I hereby apply for Union Fidelity's Hospital Plan and am enclosing the first month's premium to cover myself and all others listed above. I understand that this Policy will become effective when issued. SIGNATURE UFA 7101 3 DATE ' Sign -- Do not print S o p t . 2 0 , 1972 © 1972 Union Fidelity Life Insurance Company 184-1-12 WV

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