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Get the free DAI Policy #: 500.30.52 Page 1 of 3

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DOC1024 (Rev. 02/2009)DIVISION OF ADULT INSTITUTIONS POLICY AND PROCEDURES DAI Policy #: 500.30.52-Page 1 of 3 Original Effective Date: New Effective Date: 11/01/11 01/25/21 Supersedes: 500.30.52
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01
To fill out the DAI Policy 5003052 page, follow these steps:
02
Start by entering the policy number in the designated field.
03
Provide the insured person's details, including their name, address, and contact information.
04
Specify the effective date and duration of the policy.
05
Fill in the coverage details, such as the type of coverage, limits, and deductibles.
06
If applicable, provide information about any additional endorsements or riders included in the policy.
07
Review the filled-out form for accuracy and make any necessary corrections.
08
Once you are satisfied with the information provided, sign and date the form.
09
Submit the completed DAI Policy 5003052 page as required by your insurance provider.

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01
The DAI Policy 5003052 page is needed by individuals or organizations who have purchased a DAI insurance policy. This page serves as a document to provide specific details about the policy, including coverage, limits, and other important information. It is typically required for record-keeping purposes and may be requested during claims processing or policy renewals.
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