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Americo or its reinsurers may make a brief report to MIB which operates an information exchange on behalf of its members. Check here if the account selected above is a business account. Payor s Signature as it appears on bank records PAYOR INFORMATION Complete if Payor is different than Proposed Insured Owner. I AUTHORIZATION AND ACKNOWLEDGMENT Information regarding Your insurability will be treated as confidential. Americo Financial Life and Annuity Insurance Company Americo is a member of...
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