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ASSURING LIFE INSURANCE COMPANY PO Box 82533 Lincoln, NE 68501-2533 Toll free 800-276-7619 Avocation Questionnaire Full Name (print) Date of birth: Mo. Day Year SECTION A Automobile, Motorcycle and/or
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Start by opening the avocationmedoc form on your computer or mobile device.
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Begin by entering your personal information, such as your full name, date of birth, and contact details.
03
Move on to the next section and provide your medical history. Include any pre-existing conditions, allergies, or medications you are currently taking.
04
Proceed to fill out the section related to your avocation. Provide detailed information about the activity or hobby you are involved in, including any potential risks or dangers associated with it.
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If necessary, attach any supporting documents or medical certificates that may be required.
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Review all the information you have entered to ensure accuracy before submitting the form.
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Who needs avocationmedoc:

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