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ENTITY INFORMATION FORM CERTIFICATION AND INDEMNIFICATION AGREEMENT Owner: Contract Number: Joint Owner: ENTITY INFORMATION Please provide the following information regarding the entity: 1. Legal
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It is a specific form used for reporting certain entity information.
Entities that meet the criteria set by the governing body.
The form can be filled out online or manually according to the instructions provided by the governing body.
The purpose is to gather important information about the entity for regulatory or compliance reasons.
Details about the entity's ownership, structure, financial information, and other relevant data.
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EquiTrust Moines ET-ENTITY-2503 Proprietorship companies1 successors INDEMNIFICATION indemnify certifies undersigned assigns representations Incorporation applicable originating domicile amendments CERTIFICATION amended IA incur governmental Governing Tax

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