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I understand and agree that the Company reserves the right during the first year the policy is in force to restrict beneficiaries to designations acceptable to the Company. Globe Life And Accident Insurance Company Administrative Office Globe Life Center Oklahoma City Oklahoma 73184 Group Enrollment Form for Accidental Death Policy Benefit Amount Payment Type Annual Mode of Premium Send Premium Notice Automatic Payment Plan 3 000 spouse 1 000 each child Day of the Month to Draft Bank 01-28...
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