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DUPLICATE POLICIES FROM SOURCES OTHER THAN THE NFIP 4. DUPLICATE NFIP POLICIES STRUCTURE REMOVED FROM SFHA BY MEANS OF LOMA OR LOMR 5. SIGNATURE OF INSURED Date MM / DD / YYYY NOT REQUIRED FOR REASON 5 6 OR 22 signature of other insured Date MM / DD / YYYY FEMA Form 086-0-2 SIGNATURE OF AGENT/Producer Date MM / DD / YYYY Previously FEMA Form 81-17 F-052 Revised Aug 2010 PLEASE ATTACH ALL REQUIRED DOCUMENTS TO NFIP COPY OF CANCELLATION/ NULLIFICATION REQUEST FORM. INSURANCE NO LONGER REQUIRED...
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