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GROUP MASTER APPLICATION Important Notice Any person who knowingly and with intent to defraud any insurance company or other person files a statement of claim containing any materially false information,
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Any person who knowingly refers to an individual who is aware of certain information or facts.
Any person who has access to information or facts that they are aware of and must report it.
This information can be filled out by providing all relevant details and facts related to the situation.
The purpose is to ensure that important information is reported and documented for legal and ethical reasons.
Any relevant information or facts that the person is aware of and has knowledge about.
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