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The answers are complete and true to the best of my knowledge and belief. I realize that any false statement or misrepresentation hereon may result in loss of coverage under the policy. May refuse to sign this authorization my refusal to do so could result in coverage not being issued. reliance on this authorization or 2 other law provides AFLAC with the right to contest a claim under the policy or the policy itself. My revocation must be submitted in writing to AFLAC Policy Service 1932...
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