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CIGNAHEALTHSPRINGSALESAPPLICATIONCOVERSHEET CustomerName:AgentName:Agent ID#: Scope AVL#: Included(pleasecheckallapplicable): ApplicationPowerofAttorney(POA)NumberofPages(includingcoversheet): INSTRUCTIONS:ScopeofAppointment
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What is includedpleasecheckallapplicable?
Includexyz, Includeabc, Include123
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All individuals and businesses meeting specific criteria
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