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, 20 Dear Superintendency/Superintendence/ : For submission to the insurance supervisory authority in, regarding, (Country) (Company Name) (NAIL Cocode) I, Insurance Commissioner/Superintendent/Director
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NAIC USD Superintendency domiciled hereunto Cocode Superintendence reinsurance policyholders affixed solvency undersigned annuities jurisdictions foregoing transacted Whereof transact complied applicable subscribed accredited supervisory Commissioners cer

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